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Organization
SENIORSTAT PSYCHIATRIC PC
Active
Organization
SENIORSTAT PSYCHIATRIC PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. NANCY TALAVERA MD (OWNER)
(718) 604-5037
Entity
Organization
Contact information
Practice address
891 NORTHERN BLVD STE 201, GREAT NECK, NY 11021-5305
(516) 829-5483
(516) 829-5403
Mailing address
40 SUNSET RD S, ALBERTSON, NY 11507-1149
(718) 604-5037
(718) 363-6630
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02105604
—
NY
Enumeration date
12/08/2006
Last updated
10/06/2008
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