| Organization Name: | TLC MEDICAL CLINIC |
| NPI Number: | 1053363168 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | FRANK J NOCILLA (OWNER) |
| Mailing Address: | 14 Mountain Ledge Suite 2 Wilton |
| State: | NY US |
| Postal Code: | 128311858 |
| Phone Number: | 5182260755 |
| Fax Number: | 5182260758 |
| NPI Enumeration Date: | 05/17/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 170100000X |
| License Number: | 196889 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NY |
| Taxonomy Type: | Other Service Providers |
| Taxonomy Classification: | Medical Genetics, Ph.D. Medical Genetics |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A medical geneticist works in association with a medical specialist, is affiliated with a clinical genetics program, and serves as a consultant to medical and dental specialists. |