Basic Information
Provider Information
NPI: 1932782679
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: HARTE
FirstName: TARA
MiddleName:  
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Credential:  
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Mailing Information
Address1: 475 ALLENDALE RD STE 206
Address2:  
City: KING OF PRUSSIA
State: PA
PostalCode: 194061495
CountryCode: US
TelephoneNumber: 6102700370
FaxNumber: 6102700374
Practice Location
Address1: 341 10TH AVE STE 101
Address2:  
City: ROYERSFORD
State: PA
PostalCode: 194683807
CountryCode: US
TelephoneNumber: 6107928100
FaxNumber: 6107921535
Other Information
ProviderEnumerationDate: 04/30/2021
LastUpdateDate: 04/30/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
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IsSoleProprietor: N
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AuthorizedOfficialCredential:  
NPICertificationDate: 04/30/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
2251X0800XPT029290PAY Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic

No ID Information.


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