Healthcare Provider Details

I. General information

NPI: 1285650655
Provider Name (Legal Business Name): HENRY TALUS M.D
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/15/2006
Last Update Date: 01/30/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

451, CLARKSON AV., DEPT. OF SURGERY
BROOKLYN NY
11203
US

IV. Provider business mailing address

451, CLARKSON AV., DEPT. OF SURGERY
BROOKLYN NY
11203
US

V. Phone/Fax

Practice location:
  • Phone: 718-245-4145
  • Fax: 718-245-3011
Mailing address:
  • Phone: 718-245-4145
  • Fax: 718-245-3011

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number245342
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code208C00000X
TaxonomyColon & Rectal Surgery Physician
License Number25MA08123400
License Number StateNJ
# 3
Primary TaxonomyN
Taxonomy Code208C00000X
TaxonomyColon & Rectal Surgery Physician
License Number245342
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: