Tarallo, Phyllis A

Tarallo, Phyllis A is an individual health care provider with primary practice located at 718 Teaneck Rd , Teaneck NJ 07666-4245. She recently has 3 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Family, Physician Assistants & Advanced Practice Nursing Providers / Women's Health, Physician Assistants & Advanced Practice Nursing Providers / Primary Care. Physician Assistants & Advanced Practice Nursing Providers / Family is her primary health care specialty. Tarallo, Phyllis A can be contacted via phone (212) 305-0448.

Contact Information

Primary practice address
718 Teaneck Rd Teaneck NJ 07666-4245
Phone: (212) 305-0448
Fax: (212) 342-5600
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 333859 New York
Physician Assistants & Advanced Practice Nursing Providers / Women's Health 363LW0102X 333859 New York
Physician Assistants & Advanced Practice Nursing Providers / Primary Care 363LP2300X 333859 New York

Profile Details

NPI number 1043217300
LBN Legal business name Tarallo, Phyllis A
Credentials DNP,DCC,FNP-C
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 1st, 2005
Last updated Sep 25th, 2013 - about 12 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1043217300 NPPES
New York MEDICAID 0269026

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