Healthcare Provider Details

I. General information

NPI: 1427985340
Provider Name (Legal Business Name): KATHERINE TALLON RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/05/2026
Last Update Date: 05/05/2026
Certification Date: 05/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 PROSPECT PARK W
BROOKLYN NY
11215-5747
US

IV. Provider business mailing address

212 W 72ND ST APT PHN
NEW YORK NY
10023-2805
US

V. Phone/Fax

Practice location:
  • Phone: 212-621-7770
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0808X
TaxonomyPsychiatric/Mental Health Registered Nurse
License Number550533
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: