Individual
MS. JOHANNA D TARALLO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ANP
Contact information
Practice address
4914 W SENECA TPKE, SYRACUSE, NY 13215-2225
(315) 468-2827
(315) 469-1742
Mailing address
1210 EUCLID AVE, SYRACUSE, NY 13210-2610
(315) 474-2439
(315) 469-1742
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
F301648
NY
Other
Enumeration date
02/05/2007
Last updated
07/08/2007
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