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Individual

DR. MARC TALLENT

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PHD

Contact information

Practice address
51 5TH AVE, SUITE B, NEW YORK, NY 10003-4320
(212) 645-5795
Mailing address
1 UNIVERSITY PL, APT 9M, NEW YORK, NY 10003-4516
(212) 645-5795

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
008311-1
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
01090711
NY
Enumeration date
03/11/2007
Last updated
07/08/2007
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