Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Tara Marie Vanderburg, PA-C

Individual provider Physician Assistant · NPI 1386085082

Tara Marie Vanderburg, PA-C is a Physician Assistant in Great Neck, New York. Practices as a sole proprietor. Licensed in New York.

Licensed in
NY
In the registry since
2013
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

611 Northern Blvd Ste 200
Great Neck, NY 11021-5207
Phone: (516) 723-2663
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 016642 (NY)

Record details

NPI number1386085082
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA-C
Sole proprietorYes
NPI enumeratedJuly 10, 2013
Last updated in NPPESAugust 4, 2016

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