| Doctor Name: | DR. PHYLLIS A TARALLO |
| NPI Number: | 1043217300 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | DNP,DCC,FNP-C |
| License Number: | 333859 |
| Business Practice Address: | 718 Teaneck Rd Teaneck, NJ - 076664245 |
| Business Phone Number: | 2123050448 |
| Business Fax Number: | 2123425600 |
| Mailing Address: | Po Box 27036, NEW YORK |
| State: | NY |
| Postal Code: | 100877036 |
| Phone Number: | 2123050914 |
| Fax Number: | 2123054343 |
| NPI Enumeration Date: | 07/01/2005 |
| NPI Last Update Date: | 09/25/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LW0102X |
| License Number: | 333859 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | NY |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Women's Health |
| Taxonomy Definition: | |