Provider Demographics
NPI:1093916447
Name:PATRICIA M. TALERICO
Entity Type:Organization
Organization Name:PATRICIA M. TALERICO
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:M
Authorized Official - Last Name:TALERICO
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:732-531-0999
Mailing Address - Street 1:1300 STATE ROUTE 35
Mailing Address - Street 2:PLAZA III SUITE 101
Mailing Address - City:OCEAN
Mailing Address - State:NJ
Mailing Address - Zip Code:07712-3537
Mailing Address - Country:US
Mailing Address - Phone:732-531-0999
Mailing Address - Fax:732-531-5582
Practice Address - Street 1:1300 STATE ROUTE 35
Practice Address - Street 2:PLAZA III SUITE 101
Practice Address - City:OCEAN
Practice Address - State:NJ
Practice Address - Zip Code:07712-3537
Practice Address - Country:US
Practice Address - Phone:732-531-0999
Practice Address - Fax:732-531-5582
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-31
Last Update Date:2007-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMC03347111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJP635570OtherOXFORD
NJ551131OtherAUSHC
NJ929045OtherUNITED HEALTHCARE
NJ551131OtherAUSHC
NJ687894Medicare ID - Type Unspecified