Tara Justvig

NPI #1043617145 in Floral Park, New York

Provider Information

NPI Number: 1043617145
Entity Type: Individual
Name: Tara Justvig
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Specialist
Enumeration Date: Dec 4, 2014
Last Updated: Dec 4, 2014

Practice Location

Address: 46 PRIMROSE AVE
City: Floral Park
State: New York
ZIP Code: 11001-2516
Phone: (516) 698-1728

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Specialist	174400000X	Primary

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