Provider Demographics
NPI:1447567375
Name:TALAMO, MICHELE
Entity Type:Individual
Prefix:MRS
First Name:MICHELE
Middle Name:
Last Name:TALAMO
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 1:61 IROQUOIS RD
Mailing Address - Street 2:
Mailing Address - City:YONKERS
Mailing Address - State:NY
Mailing Address - Zip Code:10710-5031
Mailing Address - Country:US
Mailing Address - Phone:914-393-0128
Mailing Address - Fax:
Practice Address - Street 1:61 IROQUOIS RD
Practice Address - Street 2:
Practice Address - City:YONKERS
Practice Address - State:NY
Practice Address - Zip Code:10710-5031
Practice Address - Country:US
Practice Address - Phone:914-393-0128
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-14
Last Update Date:2010-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR054949-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical