Individual
MR. RAMON MODESTO TALLAJ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
571 ACADEMY STREET, NEW YORK, NY 10034
(212) 567-0550
Mailing address
25 CLARKSON CT., PARAMUS, NJ 07652
(212) 567-0550
(212) 567-6574
Taxonomy
Speciality
Code
Description
License number
State
173000000X
Legal Medicine
Primary
204704
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1719671
—
NY
Enumeration date
09/22/2006
Last updated
01/27/2014
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