Provider Demographics
NPI:1851738488
Name:DEAN TALY LLC
Entity Type:Organization
Organization Name:DEAN TALY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MISS
Authorized Official - First Name:JOAN
Authorized Official - Middle Name:
Authorized Official - Last Name:SIMPSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:856-229-9021
Mailing Address - Street 1:200 FEDERAL ST STE 213
Mailing Address - Street 2:
Mailing Address - City:CAMDEN
Mailing Address - State:NJ
Mailing Address - Zip Code:08103-1062
Mailing Address - Country:US
Mailing Address - Phone:856-229-9021
Mailing Address - Fax:888-249-3017
Practice Address - Street 1:200 FEDERAL ST STE 213
Practice Address - Street 2:
Practice Address - City:CAMDEN
Practice Address - State:NJ
Practice Address - Zip Code:08103-1062
Practice Address - Country:US
Practice Address - Phone:856-229-9021
Practice Address - Fax:888-249-3017
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-22
Last Update Date:2013-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No251B00000XAgenciesCase Management