Organization
CORINTHIAN MEDICAL IPA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RAMON MODESTO TALLAJ MD (PRESIDENT)
(212) 740-8294
Entity
Organization
Contact information
Practice address
481 FORT WASHINGTON AVE, NEW YORK, NY 10033-4654
(212) 740-8294
(212) 740-8289
Mailing address
481 FORT WASHINGTON AVE, NEW YORK, NY 10033-4654
(212) 740-8294
(212) 740-8289
Taxonomy
Speciality
Code
Description
License number
State
302F00000X
Exclusive Provider Organization
Primary
—
NY
Other
Enumeration date
05/10/2007
Last updated
07/21/2022
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