Provider Demographics
NPI:1639467269
Name:TAGLIAFERRI, STEPHEN (MSED)
Entity Type:Individual
Prefix:
First Name:STEPHEN
Middle Name:
Last Name:TAGLIAFERRI
Suffix:
Gender:M
Credentials:MSED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8974 15TH AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11228-3902
Mailing Address - Country:US
Mailing Address - Phone:917-435-4611
Mailing Address - Fax:
Practice Address - Street 1:8974 15TH AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11228-3902
Practice Address - Country:US
Practice Address - Phone:917-435-4611
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-18
Last Update Date:2012-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist