| Doctor Name: | MRS. TARA GERISE GLEESON |
| NPI Number: | 1023233913 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | CPNP |
| License Number: | 26NN09086500 |
| Business Practice Address: | 100 Madison Ave Morristown, NJ - 079606136 |
| Business Phone Number: | 9739716473 |
| Business Fax Number: | 9732907164 |
| Mailing Address: | 8 Linda Pl, DENVILLE |
| State: | NJ |
| Postal Code: | 078341005 |
| Phone Number: | 9735860085 |
| Fax Number: | 9732907164 |
| NPI Enumeration Date: | 04/16/2007 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LP0200X |
| License Number: | 26NN09086500 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NJ |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Pediatrics |
| Taxonomy Definition: | |