Organization Name: | JOHN A TALLIA |
NPI Number: | 1316110133 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | JOHN A TALLIA (OWNER) |
Mailing Address: | 7 Route 303 Tappan Plaza Tappan |
State: | NY US |
Postal Code: | 109832805 |
Phone Number: | 8453599366 |
Fax Number: | 8453599366 |
NPI Enumeration Date: | 04/13/2008 |
NPI Last Update Date: | 11/27/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 213ES0131X |
License Number: | NY003835-1 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NY |
Taxonomy Type: | Podiatric Medicine & Surgery Service Providers |
Taxonomy Classification: | Podiatrist |
Taxonomy Specialization: | Foot Surgery |
Taxonomy Definition: |