Individual
DR. MICHELLE MARIA TACLOB
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
100 MAIN ST, PATERSON, NJ 07505-1024
(973) 523-0317
(973) 684-8590
Mailing address
100 MAIN ST, PATERSON, NJ 07505-1024
(973) 523-0317
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
25MA09036900
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
25MA09036900
MEDICAL LICENSE
NJ
Enumeration date
07/11/2008
Last updated
03/30/2012
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