MEDICARE: FRANK C TALIERCIO 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	207NI0002X	Clinical & Laboratory Dermatological Immunology Physician	152791	NY

General Provider Information

NPI Number	:	1962793828
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FRANK C TALIERCIO MD

Provider Business Mailing Address
First Line	:	811 N BROADWAY
Second Line	:	SUITE 206
City	:	WHITE PLAINS
State	:	NY
Zip	:	10603-2400
Country	:	US
Telephone Number	:	914-949-7722
Fax Number	:	914-949-1122

Provider Business Practice Location Address
First Line	:	811 N BROADWAY
Second Line	:	SUITE 206
City	:	WHITE PLAINS
State	:	NY
Zip	:	10603-2400
Country	:	US
Telephone Number	:	914-949-7722
Fax Number	:	914-949-1122

Authorized Official
Title or Position	:	OWNER
Name	:	DR. FRANK C TALIERCIO
Credential	:	MD
Telephone Number	:	914-949-7722

Provider Enumeration Date	:	04/27/2011
Last Update Date	:	04/27/2011

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