Provider Demographics
NPI:1942292560
Name:TALAMO, JONATHAN H (MD)
Entity Type:Individual
Prefix:DR
First Name:JONATHAN
Middle Name:H
Last Name:TALAMO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:1601 TRAPELO RD
Mailing Address - Street 2:SUITE 184
Mailing Address - City:WALTHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02451-7333
Mailing Address - Country:US
Mailing Address - Phone:781-890-1023
Mailing Address - Fax:781-890-2507
Practice Address - Street 1:1601 TRAPELO RD
Practice Address - Street 2:SUITE 184
Practice Address - City:WALTHAM
Practice Address - State:MA
Practice Address - Zip Code:02451-7333
Practice Address - Country:US
Practice Address - Phone:781-890-1023
Practice Address - Fax:781-890-2507
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-19
Last Update Date:2013-02-12
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MA72615207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA15005OtherPILGRIM
769215OtherCONECTICARE
MA92397OtherUS HEALTHCARE
20721OtherFALLON COMMUNITY HP
23909OtherHEALTH NEW ENGLAND
MD18257OtherJOHN HANCOCK
MA719613OtherTUFTS
150612OtherHPHC
MA0012728OtherNHP-MA
MA438573OtherAETNA/US HEALTHCARE
CE5062OtherRAILROAD MEDICARE
01599703OtherTRAVELERS
MD043260634OtherCIGNA
MATAJ10073OtherBCBS-MA
MD0993538OtherAETNA/US HEALTHCARE HMO
01599703OtherTRAVELERS
MD18257OtherJOHN HANCOCK