MEDICARE: MS. TALIA SARAH DENICOFF PA

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	363A00000X	Physician Assistant		NY

General Provider Information

NPI Number	:	1215882683
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. TALIA SARAH DENICOFF PA

Provider Business Mailing Address
First Line	:	1111 AMSTERDAM AVE
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10025-1716
Country	:	US
Telephone Number	:	240-444-1902
Fax Number	:

Provider Business Practice Location Address
First Line	:	1111 AMSTERDAM AVE
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10025-1716
Country	:	US
Telephone Number	:	212-523-4000
Fax Number	:

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

Provider Enumeration Date	:	03/02/2026
Last Update Date	:	03/03/2026

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