Provider Demographics
NPI:1831221175
Name:TAGLIANI, THOMAS
Entity type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:
Last Name:TAGLIANI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11 EAST BROADWAY
Mailing Address - Street 2:13 FLOOR
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10038
Mailing Address - Country:US
Mailing Address - Phone:212-227-3088
Mailing Address - Fax:212-227-3866
Practice Address - Street 1:11 E AST BROADWAY
Practice Address - Street 2:13 FLOOR
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10038-1013
Practice Address - Country:US
Practice Address - Phone:212-227-3088
Practice Address - Fax:212-227-3866
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-12
Last Update Date:2012-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0422781223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0700XDental ProvidersDentistProsthodontics