MEDICARE: NAYIBETH TALLAJ 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	208000000X	Pediatrics Physician	31855901	NY

General Provider Information

NPI Number	:	1770043093
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NAYIBETH TALLAJ MD

Provider Business Mailing Address
First Line	:	25 CLARKSON CT
Second Line	:
City	:	PARAMUS
State	:	NJ
Zip	:	07652-5505
Country	:	US
Telephone Number	:	347-638-7007
Fax Number	:	646-337-2890

Provider Business Practice Location Address
First Line	:	2859 CRESTON AVE
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10468-1806
Country	:	US
Telephone Number	:	718-367-0211
Fax Number	:	646-337-2890

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

Provider Enumeration Date	:	03/22/2019
Last Update Date	:	12/29/2025

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