Provider Demographics
NPI:1477225621
Name:GOLZMAN, TALIA (BA)
Entity Type:Individual
Prefix:
First Name:TALIA
Middle Name:
Last Name:GOLZMAN
Suffix:
Gender:F
Credentials:BA
Other - Prefix:
Other - First Name:TALIA
Other - Middle Name:
Other - Last Name:WALTER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:649 39TH ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11232-3101
Mailing Address - Country:US
Mailing Address - Phone:718-851-3300
Mailing Address - Fax:718-972-0692
Practice Address - Street 1:649 39TH ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11232-3101
Practice Address - Country:US
Practice Address - Phone:718-851-3300
Practice Address - Fax:718-972-0692
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-05
Last Update Date:2021-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator