Healthcare Provider Details

I. General information

NPI: 1447172739
Provider Name (Legal Business Name): FELICIA TALLON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/28/2026
Last Update Date: 07/28/2026
Certification Date: 07/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

263 ROUTE 17K
NEWBURGH NY
12550-8345
US

IV. Provider business mailing address

2201 COLEMAN ST
VESTAL NY
13850-5836
US

V. Phone/Fax

Practice location:
  • Phone: 845-218-5891
  • Fax:
Mailing address:
  • Phone: 315-767-2083
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code237700000X
TaxonomyHearing Instrument Specialist
License Number14000085533
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: