MEDICARE: TALIA TRILOGY LLC

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	363LP0808X	Psychiatric/Mental Health Nurse Practitioner

General Provider Information

NPI Number	:	1497620413
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TALIA TRILOGY LLC

Provider Business Mailing Address
First Line	:	367 SAINT MARKS AVE # 1062
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11238-2268
Country	:	US
Telephone Number	:	929-559-3442
Fax Number	:	929-696-0781

Provider Business Practice Location Address
First Line	:	367 SAINT MARKS AVE # 1062
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11238-2268
Country	:	US
Telephone Number	:	929-559-3442
Fax Number	:	929-696-0781

Authorized Official
Title or Position	:	OWNER / PSYCHIATRIC NURSE PR
Name	:	TALIA MYESHA SPRUILL
Credential	:	NP
Telephone Number	:	929-559-3442

Provider Enumeration Date	:	10/08/2025
Last Update Date	:	10/08/2025

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