Healthcare Provider Details

I. General information

NPI: 1033070974
Provider Name (Legal Business Name): TALLHEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/20/2025
Last Update Date: 07/24/2026
Certification Date: 07/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8630 15TH AVE
BROOKLYN NY
11228-3409
US

IV. Provider business mailing address

8630 15TH AVE
BROOKLYN NY
11228-3409
US

V. Phone/Fax

Practice location:
  • Phone: 646-873-0651
  • Fax:
Mailing address:
  • Phone: 646-873-0651
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WW0000X
TaxonomyWound Care Registered Nurse
License Number
License Number State

VIII. Authorized Official

Name: TIMOTHY DONOHO
Title or Position: CEO
Credential: PA
Phone: 646-873-0651