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General NPI Number Information
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NPI Number | 1801887690
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Entity Type | Individual
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Provider Name | MICHELLE TAGLIAFERRI PA
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Gender | Female
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Dates
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Enumeration Date | 11/02/2005
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Last Update Date | 09/28/2012
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Provider Practice Location Address
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Address Line | 6 RHOADS DR
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City | UTICA
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State | NY
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Zip | 13502-6317
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Country | US
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Telephone | 315-733-2777
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Fax | 607-729-2773
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Provider Business Mailing Address
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Address Line | 333 HOOPER RD
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City | ENDWELL
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State | NY
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Zip | 13760-3641
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Country | US
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Telephone | 607-729-2777
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Fax | 607-729-2773
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 008452
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License Number State | NY
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