Basic Information
Provider Information
NPI: 1982916698
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: TAL
FirstName: RESHEF
MiddleName:  
NamePrefix: DR.
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
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OtherMiddleName:  
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OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: YALE SCHOOL OF MEDICINE, 333 CEDAR ST. PO BOX 208063
Address2: REPRODUCTIVE ENDOCRINOLOGY & INFERTILITY, DEPT OB/GYN
City: NEW HAVEN
State: CT
PostalCode: 065208063
CountryCode: US
TelephoneNumber: 2037645866
FaxNumber:  
Practice Location
Address1: 150 SARGENT DRIVE, 2ND FLOOR
Address2: YALE REPRODUCTIVE ENDOCRINOLOGY
City: NEW HAVEN
State: CT
PostalCode: 06511
CountryCode: US
TelephoneNumber: 2037645866
FaxNumber:  
Other Information
ProviderEnumerationDate: 07/10/2010
LastUpdateDate: 08/26/2014
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207VE0102X052789CTY Allopathic & Osteopathic PhysiciansObstetrics & GynecologyReproductive Endocrinology

No ID Information.


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