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

Individual provider Registered Nurse · NPI 1467907279

Tara Botter, RN is a Registered Nurse in Ronkonkoma, New York. Practices as a sole proprietor. Licensed in New York.

Licensed in
NY
In the registry since
2016
What do these letters mean?
RN — Registered Nurse
A licensed nurse who completed a nursing degree and passed the NCLEX-RN examination.

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Practice location Address checks out

75 Park Ave
Ronkonkoma, NY 11779-1727
Phone: (631) 605-5522
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Registered Nurse (primary) Taxonomy 163W00000X · Licence 554993 (NY)

Record details

NPI number1467907279
Entity typeIndividual (Type 1)
GenderFemale
Credentials RN
Sole proprietorYes
NPI enumeratedAugust 22, 2016
Last updated in NPPESAugust 22, 2016
Mailing address75 Park Ave, Ronkonkoma, NY 11779-1727

Other providers in Ronkonkoma