Individual
MR. PETER MICHAEL TALTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OTR
Contact information
Practice address
6000 BROCKTON DR, LOCKPORT, NY 14094-9273
(716) 433-4718
Mailing address
10 BLUEBIRD LN, AMHERST, NY 14228-1024
(716) 688-0022
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
000059
NY
Other
Enumeration date
09/29/2010
Last updated
09/29/2010
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