Individual
MS. TALIA GOTLIEB
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA, CCC-A
Contact information
Practice address
13-19 RIVER RD, FAIR LAWN, NJ 07410-1837
(201) 703-6800
(201) 703-6805
Mailing address
13-19 RIVER RD, FAIR LAWN, NJ 07410-1837
(201) 703-6800
(201) 703-6805
Taxonomy
Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
41YA00002100
NJ
237700000X
Hearing Instrument Specialist
25MG00039200
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6126600
—
NJ
Enumeration date
06/23/2006
Last updated
07/02/2014
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