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Contact Information

TARA M VANDERBURG, PA-C
611 NORTHERN BLVD
SUITE 200
GREAT NECK, NY11021-5207
 Phone: 516-723-2663
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Physician Assistant

363A00000X 97 Physician Assistant
Indicates primary specialty

NPI Profile & details for TARA M VANDERBURG · (Female)

NPI # 1386085082
Status Active
Credentials PA-C (Physician Assistant-Certified)
Entity Individual
Enumeration date 07/10/2013
Last updated 08/04/2016 - About 10 years ago
Sole proprietor 1 Yes
Identifiers
  • NY License # 016642
Hospital affiliation(s)
  • LONG ISLAND JEWISH MEDICAL CENTER - (Acute Care)
    270 - 05 76TH AVENUE
    NEW HYDE PARK, NY 11040
  • NORTH SHORE UNIVERSITY HOSPITAL - (Acute Care)
    300 COMMUNITY DRIVE
    MANHASSET, NY 11030
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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