Provider Demographics
NPI:1740288166
Name:TALMO, JUDITH MARIE (PT)
Entity type:Individual
Prefix:MS
First Name:JUDITH
Middle Name:MARIE
Last Name:TALMO
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:74B HERITAGE HLS
Mailing Address - Street 2:
Mailing Address - City:SOMERS
Mailing Address - State:NY
Mailing Address - Zip Code:10589-1519
Mailing Address - Country:US
Mailing Address - Phone:914-669-6769
Mailing Address - Fax:914-666-3970
Practice Address - Street 1:74B HERITAGE HLS
Practice Address - Street 2:
Practice Address - City:SOMERS
Practice Address - State:NY
Practice Address - Zip Code:10589-1519
Practice Address - Country:US
Practice Address - Phone:914-669-6769
Practice Address - Fax:914-669-6769
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-09
Last Update Date:2008-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY006507-1225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYQ64011Medicare ID - Type Unspecified