Basic Information
| Provider Information | |||||||||
| NPI: | 1265882690 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | TALBOTT | ||||||||
| FirstName: | WHITNEY | ||||||||
| MiddleName: | ANNE | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1254 VILLAGE AVE | ||||||||
| Address2: | |||||||||
| City: | NORTH BALDWIN | ||||||||
| State: | NY | ||||||||
| PostalCode: | 115101136 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5166595295 | ||||||||
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| Practice Location | |||||||||
| Address1: | 222 STATION PLZ N | ||||||||
| Address2: | #509 | ||||||||
| City: | MINEOLA | ||||||||
| State: | NY | ||||||||
| PostalCode: | 115013800 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5166632381 | ||||||||
| FaxNumber: | 5166638796 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/16/2016 | ||||||||
| LastUpdateDate: | 06/16/2016 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207N00000X | 39020000X | NY | Y | Allopathic & Osteopathic Physicians | Dermatology |
No ID Information.