Provider Demographics
NPI:1134578081
Name:TALARICO, JARED A (BC-HIS)
Entity type:Individual
Prefix:
First Name:JARED
Middle Name:A
Last Name:TALARICO
Suffix:
Gender:M
Credentials:BC-HIS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:228 SIMONSON CT
Mailing Address - Street 2:
Mailing Address - City:FLORHAM PARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07932-1530
Mailing Address - Country:US
Mailing Address - Phone:856-285-6560
Mailing Address - Fax:
Practice Address - Street 1:1115 CLIFTON AVE
Practice Address - Street 2:SUITE 102
Practice Address - City:CLIFTON
Practice Address - State:NJ
Practice Address - Zip Code:07013-3641
Practice Address - Country:US
Practice Address - Phone:973-777-5335
Practice Address - Fax:973-777-3348
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-10
Last Update Date:2016-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ1244237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist