| Doctor Name: | PETER LOUIS TALLERICO |
| NPI Number: | 1760722318 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | SLP |
| License Number: | 003465 |
| Business Practice Address: | 3 Farm Rd New Canaan, CT - 068406698 |
| Business Phone Number: | 2035945200 |
| Business Fax Number: | |
| Mailing Address: | 3 Farm Road, NEW CANAAN |
| State: | CT |
| Postal Code: | 068406698 |
| Phone Number: | 2035945200 |
| Fax Number: | 2065945412 |
| NPI Enumeration Date: | 02/19/2013 |
| NPI Last Update Date: | 02/19/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 235Z00000X |
| License Number: | 003465 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CT |
| Taxonomy Type: | Speech, Language and Hearing Service Providers |
| Taxonomy Classification: | Speech-Language Pathologist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A speech pathologist is a person qualified by a master |