Provider Demographics
NPI:1922829886
Name:LARINO, TARYN DENISE
Entity type:Individual
Prefix:
First Name:TARYN
Middle Name:DENISE
Last Name:LARINO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:58 PROSPECT AVE
Mailing Address - Street 2:
Mailing Address - City:BAYONNE
Mailing Address - State:NJ
Mailing Address - Zip Code:07002-4544
Mailing Address - Country:US
Mailing Address - Phone:201-471-8481
Mailing Address - Fax:
Practice Address - Street 1:58 PROSPECT AVE
Practice Address - Street 2:
Practice Address - City:BAYONNE
Practice Address - State:NJ
Practice Address - Zip Code:07002-4544
Practice Address - Country:US
Practice Address - Phone:201-471-8481
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-22
Last Update Date:2024-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY3117403225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist