Tara Boland

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

335945 Issued in NY

Practice address

535 Broadhollow Rd Ste B30
Melville, NY 11747-3719

Phone

(631) 372-1432

NPI assigned

Jan 12, 2023

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1673481600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1673481600000",
    "number": "1194439240",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "535 BROADHOLLOW RD STE B30",
            "city": "MELVILLE",
            "state": "NY",
            "postal_code": "117473719",
            "telephone_number": "631-372-1432"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "535 BROADHOLLOW RD STE B30",
            "city": "MELVILLE",
            "state": "NY",
            "postal_code": "117473719",
            "telephone_number": "631-372-1432"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOLAND",
        "first_name": "TARA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-01-12",
        "last_updated": "2023-01-12",
        "certification_date": "2023-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "335945",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stacey L Blumberg, M.S. CCC-SLP
• Richard Stephen Blume, MD
• Marilyn Blumenthal, PHD
• Stephanie Bodon, LMSW
• Bodyfirst Physical Therapy P.C.
• Heather M Bolanos, MS SLP
• Isaac Kweku Bondzie
• Leslie E Bonilla
• Marianna Borets
• Mindy Borg, LCSW

• Licensed Practical Nurse in Melville, NY
• Providers in Melville, NY by specialty
• Licensed Practical Nurse in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.