Provider Demographics
NPI:1891453163
Name:STRAUSS, TALIA
Entity Type:Individual
Prefix:
First Name:TALIA
Middle Name:
Last Name:STRAUSS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:611 GRENVILLE AVE
Mailing Address - Street 2:
Mailing Address - City:TEANECK
Mailing Address - State:NJ
Mailing Address - Zip Code:07666-2158
Mailing Address - Country:US
Mailing Address - Phone:201-994-9480
Mailing Address - Fax:
Practice Address - Street 1:611 GRENVILLE AVE
Practice Address - Street 2:
Practice Address - City:TEANECK
Practice Address - State:NJ
Practice Address - Zip Code:07666-2158
Practice Address - Country:US
Practice Address - Phone:201-994-9480
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-12-03
Last Update Date:2021-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program