Basic Information
| Provider Information | |||||||||
| NPI: | 1518354489 | ||||||||
| EntityType: | 1 | ||||||||
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| LastName: | KAISER | ||||||||
| FirstName: | TALAL | ||||||||
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| Mailing Information | |||||||||
| Address1: | 79 RETREAT AVE | ||||||||
| Address2: | HARTFORD HOSPITAL, ADULT PRIMARY CARE - BROWN STONE | ||||||||
| City: | HARTFORD | ||||||||
| State: | CT | ||||||||
| PostalCode: | 061062527 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8605450200 | ||||||||
| FaxNumber: | 8605453149 | ||||||||
| Practice Location | |||||||||
| Address1: | 1215 LEE ST | ||||||||
| Address2: | |||||||||
| City: | CHARLOTTESVILLE | ||||||||
| State: | VA | ||||||||
| PostalCode: | 229082527 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4349245219 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 04/18/2015 | ||||||||
| LastUpdateDate: | 10/12/2020 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 10/12/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208M00000X | 0101270660 | VA | Y | Allopathic & Osteopathic Physicians | Hospitalist | 207R00000X | 62079 | CT | N | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.