Provider Demographics
NPI:1710864541
Name:DELLA TORRE, TARA KATHLEEN (DPT)
Entity type:Individual
Prefix:
First Name:TARA
Middle Name:KATHLEEN
Last Name:DELLA TORRE
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:41 HIGHLAND RD
Mailing Address - Street 2:
Mailing Address - City:COLONIA
Mailing Address - State:NJ
Mailing Address - Zip Code:07067-3809
Mailing Address - Country:US
Mailing Address - Phone:732-535-1321
Mailing Address - Fax:
Practice Address - Street 1:2101 FAIRLAND RD
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20904-5427
Practice Address - Country:US
Practice Address - Phone:301-384-6161
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-21
Last Update Date:2025-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA02208200225100000X
MDCP048903T225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist