Provider Demographics
NPI:1649214271
Name:ESCOGIDO, TALYA L (PHD)
Entity Type:Individual
Prefix:DR
First Name:TALYA
Middle Name:L
Last Name:ESCOGIDO
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1810 RITTENHOUSE SQ
Mailing Address - Street 2:#908
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19103-5816
Mailing Address - Country:US
Mailing Address - Phone:215-735-0595
Mailing Address - Fax:215-735-7970
Practice Address - Street 1:1845 WALNUT ST
Practice Address - Street 2:STE 2323
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19103-4708
Practice Address - Country:US
Practice Address - Phone:215-735-0595
Practice Address - Fax:215-735-7970
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-15
Last Update Date:2008-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS005368L103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA7522310OtherAETNA
PA227042000OtherMAGELLAN
PA0461216000OtherPERSONAL CHOICE
PA680015517OtherRAILROAD MEDICARE
PA227042000OtherMAGELLAN
PA680015517OtherRAILROAD MEDICARE