Provider Demographics
NPI:1508004375
Name:TALIWAL, RITA V (DMD, MS)
Entity Type:Individual
Prefix:DR
First Name:RITA
Middle Name:V
Last Name:TALIWAL
Suffix:
Gender:F
Credentials:DMD, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18 E 50TH ST
Mailing Address - Street 2:SUITE 11A
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10022-6817
Mailing Address - Country:US
Mailing Address - Phone:212-319-5777
Mailing Address - Fax:212-319-5759
Practice Address - Street 1:18 E 50TH ST
Practice Address - Street 2:SUITE 11A
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10022-6817
Practice Address - Country:US
Practice Address - Phone:212-319-5777
Practice Address - Fax:212-319-5759
Is Sole Proprietor?:No
Enumeration Date:2009-02-01
Last Update Date:2009-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0516731223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics