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

Tara McDermott-Banta

Individual provider Specialist · NPI 1124381025

Tara McDermott-Banta is a Specialist in Massapequa, New York. Practices as a sole proprietor. Licensed in New York.

Licensed in
NY
In the registry since
2012

Practice location Address checks out

107 Hampton Blvd
Massapequa, NY 11758-7364
Phone: (516) 205-8822
Show map & directions

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

Specialties & licences

Specialist (primary) Taxonomy 174400000X · Licence 515741041 (NY)

Record details

NPI number1124381025
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedJune 17, 2012
Last updated in NPPESApril 11, 2022
Certification dateApril 11, 2022
Mailing address107 Hampton Blvd, Massapequa, NY 11758-7364

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