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Tara Ann Cardazzone

Specialist

Other Service Providers

PECOS Enrollment

Based on the most recent information from CMS, provider Tara Ann Cardazzone does not have current enrollment records in PECOS.

Part B
Medicare Part B
Not Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Not Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records 2 days ago.

Profile Details

Provider ID
1386915155
Provider Type
Individual
Full Name
Cardazzone, Tara Ann
Title
Ms.

Gender
Female
Sole Proprietor
Yes
Enumeration Date
1/25/2012
Last Updated
1/25/2012

Contact Information

Practice Location

1458 73rd St, Brooklyn, NY 11228-2112

(718) 837-2596

Unlisted Fax

Mailing Location

1458 - 73 Street, Brooklyn, NY 11228

(718) 837-2596

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 174400000X Primary	Description Specialist Other Service Providers	License 535200111 New York
Code 174400000X	Description Specialist Other Service Providers	License 447117101 New York
Code 174400000X	Description Specialist Other Service Providers	License 378735091 New York

Tara Ann Cardazzone

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

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Description

License

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Description

License

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Code

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