TARA LEIGH HERTZ (NPI# 1891288031) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1891288031 |
| Entity Type | Individual |
| Full Name | TARA LEIGH HERTZ |
| Other Name | TARA LEIGH ILSLEY |
| Credential | AG-ACNP |
| Practice Address |
39 Brentwood Rd Bay Shore NY 11706 |
| Mailing Address |
39 Brentwood Rd Bay Shore NY 11706-8031 |
| Practice Telephone | 6315917400 |
| Mailing Telephone | 6315917400 |
| Enumeration Date | 2018-06-12 |
| Last Update Date | 2018-08-15 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 163W00000X | Registered Nurse | 581597 | NY | Nursing Service Providers |
| Y | 363LA2100X |
Nurse Practitioner Specialization: Acute Care |
431384 | NY | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
39 BRENTWOOD RD |
| City | BAY SHORE |
| State | NY |
| Zip Code | 11706 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922654037 | Mahmoud Mohammedamin M Bokhari | Internal Medicine | 39 Brentwood Rd, Bay Shore, NY 11706-8031 | 2019-08-14 |
| 1235628926 | Janine Thomesen | Nurse Practitioner | 39 Brentwood Rd, Bay Shore, NY 11706-8031 | 2018-05-08 |
| 1770009326 | Crystal Wells | Nurse Practitioner | 39 Brentwood Rd, Bay Shore, NY 11706-8031 | 2017-08-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598394173 | Erin Marie Barlow | Student in an Organized Health Care Education/Training Program | Southside Emergency Department 301 East Main Street, Bay Shore, NY 11706 | 2020-04-06 |
| 1003460890 | Bay Shore Brightwaters Rescue Ambulance Inc. | Ambulance | 911 Aletta Place, Bay Shore, NY 11706 | 2019-07-30 |
| 1861980872 | Raffy Gutman | Student in an Organized Health Care Education/Training Program | Southside Hospital Family Medicine, 301 E Main St, Bay Shore, NY 11706 | 2018-04-25 |
| 1609371004 | Sengal Kelit Alazar | Student in an Organized Health Care Education/Training Program | South Side Hospital Emergency Department - Northwell, 301 East Main Street, Bay Shore, NY 11706 | 2018-03-27 |
| 1780198671 | Stefany Gabriela Armijos | Social Worker | 144 Fifth Ave, Bay Shore, NY 11706 | 2017-11-30 |
| 1417476771 | Jazmin Unda Jimenez | Licensed Practical Nurse | 236 Adams Ave, Bay Shore, NY 11706 | 2017-09-18 |
| 1013436989 | People Pushers LLC | Non-emergency Medical Transport (VAN) | 50 Corbin Ave, Suite D, Bay Shore, NY 11706 | 2017-09-12 |
| 1871011585 | Life Acupuncture & Massage Therapy P.C. | Acupuncturist | 387 East Main Street Suite 104, Bayshore, NY 11706 | 2017-09-01 |
| 1558881458 | Wilda Novembre | Licensed Practical Nurse | 1742 North Thompson Drive, Bayshore, NY 11706 | 2017-06-21 |
| 1194184085 | Georgette Prawl | Nurse's Aide | 54 1st Avenue, Bayshore, NY 11706 | 2016-02-19 |
| Find all providers in zip 11706 | ||||
| Taxonomy Code | 363LA2100X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Acute Care |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740899921 | Colleen Stubbs | Nurse Practitioner | 301 E Main St, Bay Shore, NY 11706-8458 | 2020-07-23 |
| 1235628926 | Janine Thomesen | Nurse Practitioner | 39 Brentwood Rd, Bay Shore, NY 11706-8031 | 2018-05-08 |
| 1679952162 | Andrew S Rotjan | Nurse Practitioner | 301 E Main St, Bay Shore, NY 11706-8408 | 2015-05-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528669975 | Fereshta Azizy | Nurse Practitioner | 1806 Parsons Blvd, Whitestone, NY 11357-3042 | 2020-11-03 |
| 1598365579 | Emily Rose Fitzpatrick | Nurse Practitioner | 530 1st Ave # Hcc12, New York, NY 10016-6402 | 2020-10-28 |
| 1467069583 | Ma Teresa Justine V Balboa | Nurse Practitioner | 19 Low Ln, Levittown, NY 11756-4511 | 2020-09-24 |
| 1588270151 | Cynthia Li | Nurse Practitioner | 5312 80th St, Elmhurst, NY 11373-4732 | 2020-09-19 |
| 1356956312 | Maria Nagel | Nurse Practitioner | 350 E 30th St Apt 1b, New York, NY 10016-8307 | 2020-09-15 |
| 1699389817 | John Paul Talmadge Cagigas | Nurse Practitioner | 402 N Indiana Ave, Lindenhurst, NY 11757-3423 | 2020-09-04 |
| 1891308615 | Peter Marusca | Nurse Practitioner | 4610 61st St Apt 14a, Woodside, NY 11377-5731 | 2020-08-31 |
| 1760095269 | Elizabeth Meder Demas | Nurse Practitioner | 141 Ridge St Apt A, New York, NY 10002-1804 | 2020-08-25 |
| 1093328593 | Melissa Moulton | Nurse Practitioner | 204 E 77th St Apt 2d, New York, NY 10075-2107 | 2020-08-25 |
| 1942819636 | Ruby Judith Maloco Garzon | Nurse Practitioner | 222 Peters Ave, East Meadow, NY 11554-1525 | 2020-07-28 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on TARA LEIGH HERTZ.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.