Provider Demographics
NPI:1518354489
Name:KAISER, TALAL
Entity Type:Individual
Prefix:
First Name:TALAL
Middle Name:
Last Name:KAISER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:79 RETREAT AVE
Mailing Address - Street 2:HARTFORD HOSPITAL, ADULT PRIMARY CARE - BROWN STONE
Mailing Address - City:HARTFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06106-2527
Mailing Address - Country:US
Mailing Address - Phone:860-545-0200
Mailing Address - Fax:860-545-3149
Practice Address - Street 1:1215 LEE ST
Practice Address - Street 2:
Practice Address - City:CHARLOTTESVILLE
Practice Address - State:VA
Practice Address - Zip Code:22908-2527
Practice Address - Country:US
Practice Address - Phone:434-924-5219
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-04-18
Last Update Date:2020-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101270660208M00000X
CT62079207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine