Provider Demographics
NPI:1558697292
Name:TALATY, PALLAVI (RPH)
Entity Type:Individual
Prefix:MS
First Name:PALLAVI
Middle Name:
Last Name:TALATY
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:29455 N CAVE CREEK RD
Mailing Address - Street 2:
Mailing Address - City:CAVE CREEK
Mailing Address - State:AZ
Mailing Address - Zip Code:85331-3245
Mailing Address - Country:US
Mailing Address - Phone:480-538-7132
Mailing Address - Fax:480-538-7134
Practice Address - Street 1:29455 N CAVE CREEK RD
Practice Address - Street 2:
Practice Address - City:CAVE CREEK
Practice Address - State:AZ
Practice Address - Zip Code:85331-3245
Practice Address - Country:US
Practice Address - Phone:480-538-7132
Practice Address - Fax:480-538-7134
Is Sole Proprietor?:No
Enumeration Date:2009-10-31
Last Update Date:2009-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZS015374183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist