1942292560 NPI number — DR. JONATHAN H TALAMO MD

Table of content: DR. JONATHAN H TALAMO MD (NPI 1942292560)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1942292560 NPI number — DR. JONATHAN H TALAMO MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
TALAMO
Provider First Name:
JONATHAN
Provider Middle Name:
H
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1942292560
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/12/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1601 TRAPELO RD
Provider Second Line Business Mailing Address:
SUITE 184
Provider Business Mailing Address City Name:
WALTHAM
Provider Business Mailing Address State Name:
MA
Provider Business Mailing Address Postal Code:
02451-7333
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
781-890-1023
Provider Business Mailing Address Fax Number:
781-890-2507

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1601 TRAPELO RD
Provider Second Line Business Practice Location Address:
SUITE 184
Provider Business Practice Location Address City Name:
WALTHAM
Provider Business Practice Location Address State Name:
MA
Provider Business Practice Location Address Postal Code:
02451-7333
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
781-890-1023
Provider Business Practice Location Address Fax Number:
781-890-2507
Provider Enumeration Date:
08/19/2005

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207W00000X , with the licence number:  72615 , registered in the state of MA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 15005 . This is a "PILGRIM" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 769215 . This is a "CONECTICARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 92397 . This is a "US HEALTHCARE" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 20721 . This is a "FALLON COMMUNITY HP" identifier . This identifiers is of the category "OTHER".
  • Identifier: 23909 . This is a "HEALTH NEW ENGLAND" identifier . This identifiers is of the category "OTHER".
  • Identifier: 18257 . This is a "JOHN HANCOCK" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 719613 . This is a "TUFTS" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 150612 . This is a "HPHC" identifier . This identifiers is of the category "OTHER".
  • Identifier: 0012728 . This is a "NHP-MA" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 438573 . This is a "AETNA/US HEALTHCARE" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: CE5062 . This is a "RAILROAD MEDICARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 01599703 . This is a "TRAVELERS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 043260634 . This is a "CIGNA" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: TAJ10073 . This is a "BCBS-MA" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 0993538 . This is a "AETNA/US HEALTHCARE HMO" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".




Copyright © 2007-2024 www.npivalidator.com