MEDICARE: DR. ROBERT TAGLIA MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	169178-1	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	27E931	OTHER	NY	BLUES
2	1P0009	OTHER	NY	PHS
3	9714520	OTHER	NY	GHI
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	GP331	OTHER	NY	OXFORD

General Provider Information

NPI Number	:	1184624165
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ROBERT TAGLIA MD

Provider Business Mailing Address
First Line	:	35 HUNTER DR
Second Line	:
City	:	EASTCHESTER
State	:	NY
Zip	:	10709-5205
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1577 HONE AVE
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10461-1505
Country	:	US
Telephone Number	:	718-863-0500
Fax Number	:	718-823-1399

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/29/2005
Last Update Date	:	07/08/2007

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Directions to “ DR. ROBERT TAGLIA MD” Practice Location

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