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General NPI Number Information
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NPI Number | 1245452622
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Entity Type | Organization
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Legal Business Name | MARC TARLE M.D, PC
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Dates
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Enumeration Date | 05/03/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 20 SQUADRON BLVD #560
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City | NEW CITY
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State | NY
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Zip | 10956
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Country | US
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Telephone | 845-639-9650
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Fax | 845-639-0727
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Provider Business Mailing Address
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Address Line | 20 SQUADRON BLVD #560
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City | NEW CITY
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State | NY
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Zip | 10956
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Country | US
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Telephone | 845-639-9650
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Fax | 845-639-0727
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Authorized Official
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Title or Position | PSYCHIATRIST
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Name | MARC E TARLE
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Credential | M.D.
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Telephone | 845-639-9650
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 141348
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License Number State | NY
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