Provider Demographics
NPI:1982135463
Name:SINGER-CLARK, TALIA L (MD)
Entity Type:Individual
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First Name:TALIA
Middle Name:L
Last Name:SINGER-CLARK
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Gender:F
Credentials:MD
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Mailing Address - Street 1:960 MASSACHUSETTS AVENUE
Mailing Address - Street 2:FL 2
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02118-2690
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1 BOSTON MEDICAL CTR PL
Practice Address - Street 2:DOWLING 5TH FL
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02118-2908
Practice Address - Country:US
Practice Address - Phone:617-414-4465
Practice Address - Fax:617-414-3345
Is Sole Proprietor?:No
Enumeration Date:2017-03-25
Last Update Date:2024-04-17
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Provider Licenses
StateLicense IDTaxonomies
MA2820322083A0300X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No2083A0300XAllopathic & Osteopathic PhysiciansPreventive MedicineAddiction Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH3114929Medicaid
MA110127101AMedicaid