Provider Demographics
NPI:1568834406
Name:TALYA, DANNY S (NP)
Entity Type:Individual
Prefix:MR
First Name:DANNY
Middle Name:S
Last Name:TALYA
Suffix:
Gender:M
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:660 WOODWARD AVE STE 2430
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48226-3502
Mailing Address - Country:US
Mailing Address - Phone:313-457-9355
Mailing Address - Fax:313-447-2444
Practice Address - Street 1:660 WOODWARD AVE STE 2430
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48226-3502
Practice Address - Country:US
Practice Address - Phone:313-457-9355
Practice Address - Fax:313-447-2444
Is Sole Proprietor?:No
Enumeration Date:2015-10-29
Last Update Date:2020-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIF0815531363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily