MEDICARE: TAHL COLEN 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	207YX0901X	Otology & Neurotology Physician	243017	NY
2	207Y00000X	Otolaryngology Physician	243017	NY

General Provider Information

NPI Number	:	1619171931
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TAHL COLEN MD

Provider Business Mailing Address
First Line	:	660 WHITE PLAINS RD FL 4
Second Line	:
City	:	TARRYTOWN
State	:	NY
Zip	:	10591-5139
Country	:	US
Telephone Number	:	914-984-2546
Fax Number	:

Provider Business Practice Location Address
First Line	:	300 CADMAN PLZ W STE 1301
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11201-3229
Country	:	US
Telephone Number	:	718-208-4449
Fax Number	:	718-208-4663

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

Provider Enumeration Date	:	06/12/2007
Last Update Date	:	04/02/2019

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