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1720144728
TARA MARY RUSSIAN
ELMHURST, NY
NPI
1720144728
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
1041C0700X Social Worker, Clinical
(Licence: NY P059328)
Enumeration Date
2006-12-28
Last Update Date
2007-07-08
Business Address
Miss TARA MARY RUSSIAN LMSW
80TH ST & 41ST AVE
ELMHURST, NY 11373-1329
Phone number: 718-334-3900
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Mailing Address
Miss TARA MARY RUSSIAN LMSW
7901 BROADWAY MANAGED CARE, D1-01
ELMHURST, NY 11373-1329
Phone number: 718-334-1921
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