Provider Demographics
NPI:1649353426
Name:TALAMO FAMILY PRACTICE GROUP, PC
Entity type:Organization
Organization Name:TALAMO FAMILY PRACTICE GROUP, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:J
Authorized Official - Last Name:TALAMO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:610-831-2280
Mailing Address - Street 1:555 SECOND AVENUE
Mailing Address - Street 2:SUITE D201
Mailing Address - City:COLLEGEVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:19426
Mailing Address - Country:US
Mailing Address - Phone:610-831-2280
Mailing Address - Fax:610-489-1953
Practice Address - Street 1:555 SECOND AVENUE
Practice Address - Street 2:SUITE D201
Practice Address - City:COLLEGEVILLE
Practice Address - State:PA
Practice Address - Zip Code:19426
Practice Address - Country:US
Practice Address - Phone:610-831-2280
Practice Address - Fax:610-489-1953
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-23
Last Update Date:2021-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA271500OtherAETNA HMO
PA30022103OtherKEYSTONE MERCY
PA50050123OtherCAPITAL BLUE CROSS
PA1685353OtherPENNSYLVANIA BLUE SHIELD
PA2362341001OtherKEYSTONE HEALTH PLAN EAST
PA090070Medicare ID - Type Unspecified