Provider Demographics
NPI:1144929670
Name:ILARRAZA, TAHIRA SANCHEZ (DNP-FNP)
Entity type:Individual
Prefix:DR
First Name:TAHIRA
Middle Name:SANCHEZ
Last Name:ILARRAZA
Suffix:
Gender:F
Credentials:DNP-FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:51 HANSEN AVE
Mailing Address - Street 2:
Mailing Address - City:NEW CITY
Mailing Address - State:NY
Mailing Address - Zip Code:10956-3134
Mailing Address - Country:US
Mailing Address - Phone:845-825-9706
Mailing Address - Fax:
Practice Address - Street 1:21 CHESTNUT ST
Practice Address - Street 2:
Practice Address - City:SPRING VALLEY
Practice Address - State:NY
Practice Address - Zip Code:10977-5533
Practice Address - Country:US
Practice Address - Phone:845-371-0034
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-02-23
Last Update Date:2023-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF350954-01363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily