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General NPI Number Information
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NPI Number | 1356764740
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Entity Type | Individual
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Provider Name | AMANDA RAE TALERICO NP
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Gender | Female
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Dates
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Enumeration Date | 01/21/2014
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Last Update Date | 07/17/2026
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Provider Practice Location Address
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Address Line | 168 CENTRE ST FL 2
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City | NEW YORK
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State | NY
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Zip | 10013-6501
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Country | US
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Telephone | 212-966-2178
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Fax |
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Provider Business Mailing Address
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Address Line | 366 5TH AVE FL 4
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City | NEW YORK
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State | NY
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Zip | 10001-2241
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | 30 306548
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 22 616794
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License Number State | NY
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