Provider Demographics
NPI:1467681403
Name:TALARICO, TIFFANY MICHELLE (DC)
Entity Type:Individual
Prefix:DR
First Name:TIFFANY
Middle Name:MICHELLE
Last Name:TALARICO
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 1:42 E MAIDEN ST
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:PA
Mailing Address - Zip Code:15301-4912
Mailing Address - Country:US
Mailing Address - Phone:724-225-2225
Mailing Address - Fax:724-225-5746
Practice Address - Street 1:42 E MAIDEN ST
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:PA
Practice Address - Zip Code:15301-4912
Practice Address - Country:US
Practice Address - Phone:724-225-2225
Practice Address - Fax:724-225-5746
Is Sole Proprietor?:No
Enumeration Date:2009-07-13
Last Update Date:2015-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC010137111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1025375830001Medicaid
PA167783MR716Medicare PIN