Healthcare Provider Details

I. General information

NPI: 1306991195
Provider Name (Legal Business Name): ANTHONY P TALIERI JR. M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/24/2007
Last Update Date: 01/27/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

336 THOMPSON RD
WEBSTER MA
01570-1509
US

IV. Provider business mailing address

PO BOX 415348
BOSTON MA
02241-0001
US

V. Phone/Fax

Practice location:
  • Phone: 508-943-5224
  • Fax: 508-949-2211
Mailing address:
  • Phone: 800-225-8885
  • Fax: 508-334-1977

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number241683
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: