Provider Demographics
NPI:1295405181
Name:FRANKFORT, TALI
Entity Type:Individual
Prefix:
First Name:TALI
Middle Name:
Last Name:FRANKFORT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:195 MAPLE AVE
Mailing Address - Street 2:
Mailing Address - City:RED BANK
Mailing Address - State:NJ
Mailing Address - Zip Code:07701-1726
Mailing Address - Country:US
Mailing Address - Phone:732-749-2438
Mailing Address - Fax:
Practice Address - Street 1:4000 ROUTE 66 STE 331
Practice Address - Street 2:
Practice Address - City:TINTON FALLS
Practice Address - State:NJ
Practice Address - Zip Code:07753-7300
Practice Address - Country:US
Practice Address - Phone:732-988-3441
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-14
Last Update Date:2024-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ35SI00720000103G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist