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

Tara Broccolo

Individual provider Specialist · NPI 1821495581

Tara Broccolo is a Specialist in Irondequoit, New York. Practices as a sole proprietor. Licensed in New York.

Licensed in
NY
In the registry since
2014
Claim this listing Report a problem Suggest an edit

Practice location Address checks out

2111 Hudson Ave
Irondequoit, NY 14617-4346
Phone: (585) 520-1783
Show map & directions

Directions in Google Maps · Apple Maps · OpenStreetMap

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

Specialties & licences

Specialist (primary) Taxonomy 174400000X · Licence 649366951 (NY)

Record details

NPI number1821495581
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedNovember 24, 2014
Last updated in NPPESNovember 24, 2014
Mailing address1628 Glendowan Ter, Webster, NY 14580-8571

Other providers in Irondequoit