Individual
DR. IGOR A. TALIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
5115 BEACH CHANNEL DR, PMC, FAR ROCKAWAY, NY 11691-1042
(718) 734-3027
Mailing address
2728 KINGS HWY APT F11, BROOKLYN, NY 11229-1780
(917) 902-0933
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
253007
NY
Other
Enumeration date
05/23/2007
Last updated
06/05/2009
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