| Doctor Name: | MRS. TARA KIMBALL-TUCKER |
| NPI Number: | 1306059340 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | |
| License Number: | 011052 |
| Business Practice Address: | 141 East Main St. Huntington, NY - 117432852 |
| Business Phone Number: | 6314219111 |
| Business Fax Number: | |
| Mailing Address: | 511 Washington Dr., CENTERPORT |
| State: | NY |
| Postal Code: | 117211806 |
| Phone Number: | 6314279786 |
| Fax Number: | |
| NPI Enumeration Date: | 05/07/2007 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 225100000X |
| License Number: | 011052 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NY |
| Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Taxonomy Classification: | Physical Therapist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT |