Provider Demographics
NPI:1235292830
Name:TALAY, NICOLE BARBARA (DC)
Entity Type:Individual
Prefix:DR
First Name:NICOLE
Middle Name:BARBARA
Last Name:TALAY
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22 LEARY LN
Mailing Address - Street 2:
Mailing Address - City:NESCONSET
Mailing Address - State:NY
Mailing Address - Zip Code:11767-1810
Mailing Address - Country:US
Mailing Address - Phone:631-584-5434
Mailing Address - Fax:
Practice Address - Street 1:187 LAKE AVE STE 101
Practice Address - Street 2:
Practice Address - City:SAINT JAMES
Practice Address - State:NY
Practice Address - Zip Code:11780-2933
Practice Address - Country:US
Practice Address - Phone:631-335-1569
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX0091491111NI0900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NI0900XChiropractic ProvidersChiropractorInternist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYX3B791Medicare ID - Type Unspecified