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Contact Information

TARA ACCAVALLO, FNP-BC
5036 JERICHO TPKE STE 207
COMMACK, NY11725-2812
 Phone: 631-486-8372
 Fax: 631-486-8374
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Family

363LF0000X 50 Nurse Practitioner
 

Primary Care

363LP2300X 50 Nurse Practitioner
 

Registered Nurse

163W00000X
Indicates primary specialty

NPI Profile & details for TARA ACCAVALLO · (Female)

NPI # 1013162346
Status Active
Credentials FNP-BC (Family Nurse Practitioner)
Entity Individual
Enumeration date 12/01/2008
Last updated 07/22/2024 - More than a year ago
Sole proprietor 1 No
Identifiers
  • NY License # 454839
  • NY License # F353276
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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