Individual
DR. MATTHEW TARELLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
84 BROAD ST, GLENS FALLS, NY 12801-4381
(518) 798-9538
(518) 798-9573
Mailing address
84 BROAD ST, GLENS FALLS, NY 12801-4381
(518) 798-9538
(518) 798-9573
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
279394
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
279394
NYS LICENSE #
NY
Enumeration date
06/19/2012
Last updated
05/28/2015
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