TARA MCDERMOTT-BANTA

MASSAPEQUA, NY
NPI1124381025
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy174400000X Specialist
(Licence: NY  515741041)
Enumeration Date2012-06-17
Last Update Date2022-04-11
Business Address
TARA MCDERMOTT-BANTA
107 HAMPTON BLVD
MASSAPEQUA, NY 11758-7364
Phone number: 516-205-8822
Mailing Address
TARA MCDERMOTT-BANTA
107 HAMPTON BLVD
MASSAPEQUA, NY 11758-7364
Phone number: 516-205-8822
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