Provider Demographics
NPI:1831953017
Name:TALBOT, LAURA MARIE (RD)
Entity type:Individual
Prefix:MS
First Name:LAURA
Middle Name:MARIE
Last Name:TALBOT
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16 TRUESDALE LAKE DR
Mailing Address - Street 2:
Mailing Address - City:SOUTH SALEM
Mailing Address - State:NY
Mailing Address - Zip Code:10590-1314
Mailing Address - Country:US
Mailing Address - Phone:914-505-2942
Mailing Address - Fax:
Practice Address - Street 1:16 TRUESDALE LAKE DR
Practice Address - Street 2:
Practice Address - City:SOUTH SALEM
Practice Address - State:NY
Practice Address - Zip Code:10590-1314
Practice Address - Country:US
Practice Address - Phone:914-505-2942
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-08
Last Update Date:2024-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY86054679133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered