MEDICARE: DR. WESLEY ROLF TZALL M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RC0000X	Cardiovascular Disease Physician	131462	NY
2	207UN0901X	Nuclear Cardiology Physician	131462	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1508853276
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. WESLEY ROLF TZALL M.D.

Provider Business Mailing Address
First Line	:	170 WILLIAM ST
Second Line	:	SUITE 814
City	:	NEW YORK
State	:	NY
Zip	:	10038-2612
Country	:	US
Telephone Number	:	212-608-7422
Fax Number	:	212-312-5266

Provider Business Practice Location Address
First Line	:	170 WILLIAM ST
Second Line	:	SUITE 814
City	:	NEW YORK
State	:	NY
Zip	:	10038-2612
Country	:	US
Telephone Number	:	212-608-7422
Fax Number	:	212-312-5266

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/28/2005
Last Update Date	:	09/11/2025

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