Healthcare Provider Details

I. General information

NPI: 1730310798
Provider Name (Legal Business Name): JOSEPH TALIERCIO APRN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/06/2009
Last Update Date: 09/30/2025
Certification Date: 09/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 RETREAT AVE SUITE 605
HARTFORD CT
06106-2528
US

IV. Provider business mailing address

100 RETREAT AVE STE 811
HARTFORD CT
06106-2528
US

V. Phone/Fax

Practice location:
  • Phone: 860-244-0148
  • Fax: 860-493-1852
Mailing address:
  • Phone: 860-522-5712
  • Fax: 860-520-4270

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number004136
License Number StateCT
# 2
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number004136
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: