Provider Demographics
NPI:1912186438
Name:TALIERCIO, CHRISTINE A (CA)
Entity Type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:A
Last Name:TALIERCIO
Suffix:
Gender:F
Credentials:CA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11 CLINTON DR
Mailing Address - Street 2:
Mailing Address - City:MANALAPAN
Mailing Address - State:NJ
Mailing Address - Zip Code:07726-2928
Mailing Address - Country:US
Mailing Address - Phone:732-577-0886
Mailing Address - Fax:
Practice Address - Street 1:100 CRAIG RD
Practice Address - Street 2:SUITE 104
Practice Address - City:MANALAPAN
Practice Address - State:NJ
Practice Address - Zip Code:07726-8787
Practice Address - Country:US
Practice Address - Phone:732-431-0015
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-01
Last Update Date:2012-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MZ00025200171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist