Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Mrs. Tara Marie Sullivan

Individual provider Specialist · NPI 1205199601

Mrs. Tara Marie Sullivan is a Specialist in Whitestone, New York. Licensed in New York. Registered with an NPI since 2012.

Licensed in
NY
In the registry since
2012

Practice location Address checks out

14911 12th Ave
Whitestone, NY 11357-1725
Phone: (516) 576-2040
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Specialist (primary) Taxonomy 174400000X · Licence 1718799 (NY)

Record details

NPI number1205199601
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedJune 20, 2012
Last updated in NPPESJune 20, 2012

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