Basic Information
Provider Information
NPI: 1386879880
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: TAGLIENTI
FirstName: ANTHONY
MiddleName: JOHN
NamePrefix: DR.
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 6 LOWELL AVE
Address2:  
City: NEW HYDE PARK
State: NY
PostalCode: 110402810
CountryCode: US
TelephoneNumber: 5163264160
FaxNumber:  
Practice Location
Address1: 6 LOWELL AVE
Address2:  
City: NEW HYDE PARK
State: NY
PostalCode: 110402810
CountryCode: US
TelephoneNumber: 5163264160
FaxNumber:  
Other Information
ProviderEnumerationDate: 05/28/2009
LastUpdateDate: 10/05/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 10/05/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
174400000X  N Other Service ProvidersSpecialist 
2086S0122XMD446281PAN Allopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive Surgery
2086S0122X280332NYY Allopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive Surgery

No ID Information.


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