Healthcare Provider Details

I. General information

NPI: 1386640696
Provider Name (Legal Business Name): ROHIT TALWAR M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/22/2005
Last Update Date: 11/19/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 WEST MAIN STREET, NSLIJ CENTER FOR SPECIALTY CARE SUITE 204
BABYLON NY
11702-3028
US

IV. Provider business mailing address

500 WEST MAIN STREET, NSLIJ CENTER FOR SPECIALTY CARE SUITE 204
BABYLON NY
11702-3028
US

V. Phone/Fax

Practice location:
  • Phone: 631-539-5400
  • Fax: 631-539-5401
Mailing address:
  • Phone: 631-539-5400
  • Fax: 631-539-5401

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080P0202X
TaxonomyPediatric Cardiology Physician
License Number203994
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: