Provider Demographics
NPI:1063477990
Name:D'ITALIA, TALITHA ROBINSON (OD)
Entity Type:Individual
Prefix:DR
First Name:TALITHA
Middle Name:ROBINSON
Last Name:D'ITALIA
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:TALITHA
Other - Middle Name:GAY
Other - Last Name:ROBINSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3105 LIMESTONE RD
Mailing Address - Street 2:SUITE 102
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19808-2147
Mailing Address - Country:US
Mailing Address - Phone:302-998-1395
Mailing Address - Fax:302-998-6784
Practice Address - Street 1:3105 LIMESTONE RD
Practice Address - Street 2:SUITE 102
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19808-2147
Practice Address - Country:US
Practice Address - Phone:302-998-1395
Practice Address - Fax:302-998-6784
Is Sole Proprietor?:No
Enumeration Date:2006-04-20
Last Update Date:2014-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOEG000728152W00000X
DEI3-0001329152W00000X, 152WV0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
No152WV0400XEye and Vision Services ProvidersOptometristVision Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
032037QE7Medicare ID - Type Unspecified
U77255Medicare UPIN