Healthcare Provider Details

I. General information

NPI: 1871580761
Provider Name (Legal Business Name): JAMES AUSTIN TALCOTT MDSM
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/05/2005
Last Update Date: 10/12/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10 UNION SQ E
NEW YORK NY
10003-3314
US

IV. Provider business mailing address

PO BOX 95000-2441
PHILADELPHIA PA
19195-2441
US

V. Phone/Fax

Practice location:
  • Phone: 212-844-6450
  • Fax:
Mailing address:
  • Phone: 212-604-6000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RX0202X
TaxonomyMedical Oncology Physician
License Number260052
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: