Provider Demographics
NPI:1528228194
Name:JOSEPH JOHN TARTAGLIA, M.D.,P.C.
Entity Type:Organization
Organization Name:JOSEPH JOHN TARTAGLIA, M.D.,P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:JOHN
Authorized Official - Last Name:TARTAGLIA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:914-946-3388
Mailing Address - Street 1:311 NORTH ST
Mailing Address - Street 2:SUITE 402
Mailing Address - City:WHITE PLAINS
Mailing Address - State:NY
Mailing Address - Zip Code:10605-2217
Mailing Address - Country:US
Mailing Address - Phone:914-946-3388
Mailing Address - Fax:914-946-5940
Practice Address - Street 1:311 NORTH ST
Practice Address - Street 2:SUITE 402
Practice Address - City:WHITE PLAINS
Practice Address - State:NY
Practice Address - Zip Code:10605-2217
Practice Address - Country:US
Practice Address - Phone:914-946-3388
Practice Address - Fax:914-946-5940
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-16
Last Update Date:2008-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY173101207RC0000X, 207RG0300X
CT038971207RC0000X, 207RG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
No207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01175199Medicaid
CTC02930Medicare PIN
NYE48808Medicare UPIN
NY41F731Medicare PIN