Provider Demographics
NPI:1225512825
Name:TALIFERRO, LATONYA (DPC)
Entity Type:Individual
Prefix:DR
First Name:LATONYA
Middle Name:
Last Name:TALIFERRO
Suffix:
Gender:F
Credentials:DPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:48 HAMPSHIRE GLEN PKWY
Mailing Address - Street 2:
Mailing Address - City:HAMPTON
Mailing Address - State:VA
Mailing Address - Zip Code:23669-4806
Mailing Address - Country:US
Mailing Address - Phone:757-218-5640
Mailing Address - Fax:
Practice Address - Street 1:2502 BUILD AMERICA DR
Practice Address - Street 2:
Practice Address - City:HAMPTON
Practice Address - State:VA
Practice Address - Zip Code:23666-3223
Practice Address - Country:US
Practice Address - Phone:757-218-5640
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-09-19
Last Update Date:2018-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1744P3200XOther Service ProvidersSpecialistProsthetics Case Management