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NPI Code Detail

MEDICARE: JEAN TALBOT RPAC

MEDICARE:   JEAN  TALBOT  RPAC
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
1363A00000XPhysician Assistant004891-1NY

General Provider Information

NPI Number : 1790904886
Entity Type Code : Individual
Provider Name (Legal Business Name) : JEAN TALBOT RPAC
Provider Business Mailing Address
First Line : 9 W SAND LAKE RD
Second Line :
City : WYNANTSKILL
State : NY
Zip : 12198-7954
Country : US
Telephone Number : 518-283-1974
Fax Number : 518-283-2018
Provider Business Practice Location Address
First Line : 9 W SAND LAKE RD
Second Line :
City : WYNANTSKILL
State : NY
Zip : 12198-7954
Country : US
Telephone Number : 518-283-1974
Fax Number : 518-283-2018
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/25/2007
Last Update Date : 01/11/2010

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Directions to “ JEAN TALBOT RPAC” Practice Location

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