Organization Name: | STEVEN R TARASZKA PC |
NPI Number: | 1629251822 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | STEVEN ROBERT TARASZKA (PRESIDENT) |
Mailing Address: | 924 West Spring St Monroe |
State: | GA US |
Postal Code: | 30655 |
Phone Number: | 7702674455 |
Fax Number: | 7702677495 |
NPI Enumeration Date: | 12/11/2007 |
NPI Last Update Date: | 12/11/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | 208VP0014X |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |