Healthcare Provider Details
I. General information
NPI: 1720065287
Provider Name (Legal Business Name): ROSS JAMES TALIANO M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 12/27/2005
Last Update Date: 06/14/2011
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
593 EDDY ST RHODE ISLAND HOSPITAL DEPARTMENT OF PATHOLOGY
PROVIDENCE RI
02903-4923
US
IV. Provider business mailing address
593 EDDY ST RHODE ISLAND HOSPITAL DEPARTMENT OF PATHOLOGY
PROVIDENCE RI
02903-4923
US
V. Phone/Fax
- Phone: 401-444-5057
- Fax: 401-444-8514
- Phone: 401-444-5057
- Fax: 401-444-8514
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207ZP0101X |
| Taxonomy | Anatomic Pathology Physician |
| License Number | MD13641 |
| License Number State | RI |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207ZP0102X |
| Taxonomy | Anatomic Pathology & Clinical Pathology Physician |
| License Number | 159498 |
| License Number State | MA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: