Provider Demographics
NPI:1043436017
Name:MOTY N. TAL M.D. LLC
Entity Type:Organization
Organization Name:MOTY N. TAL M.D. LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MOTY
Authorized Official - Middle Name:N
Authorized Official - Last Name:TAL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:732-517-0555
Mailing Address - Street 1:1300 STATE ROUTE 35
Mailing Address - Street 2:PLAZA 2 SUITE 202
Mailing Address - City:OCEAN
Mailing Address - State:NJ
Mailing Address - Zip Code:07712-3537
Mailing Address - Country:US
Mailing Address - Phone:732-517-0555
Mailing Address - Fax:732-517-1359
Practice Address - Street 1:1300 STATE ROUTE 35
Practice Address - Street 2:PLAZA 2 SUITE 202
Practice Address - City:OCEAN
Practice Address - State:NJ
Practice Address - Zip Code:07712-3537
Practice Address - Country:US
Practice Address - Phone:732-517-0555
Practice Address - Fax:732-517-1359
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-18
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJC54552Medicare UPIN
NJE96976Medicare UPIN