Healthcare Provider Details

I. General information

NPI: 1912136201
Provider Name (Legal Business Name): DR. TALIA SCHECHTER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/07/2009
Last Update Date: 07/07/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 E NEWTON ST G-401
BOSTON MA
02118-2308
US

IV. Provider business mailing address

100 E NEWTON ST G-401
BOSTON MA
02118-2308
US

V. Phone/Fax

Practice location:
  • Phone: 802-578-0769
  • Fax: 617-638-4713
Mailing address:
  • Phone: 802-578-0769
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License NumberDL10634
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: