Basic Information
Provider Information
NPI: 1801041744
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: TAGLIATI
FirstName: KELSI
MiddleName: ERIN
NamePrefix:  
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 3399 TRINDLE RD
Address2:  
City: CAMP HILL
State: PA
PostalCode: 170114407
CountryCode: US
TelephoneNumber: 7177615530
FaxNumber: 7177377197
Practice Location
Address1: 3399 TRINDLE RD
Address2:  
City: CAMP HILL
State: PA
PostalCode: 170114407
CountryCode: US
TelephoneNumber: 7177615530
FaxNumber: 7177377197
Other Information
ProviderEnumerationDate: 11/19/2008
LastUpdateDate: 12/03/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 12/03/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207LP2900XMT183928PAN Allopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
207LP2900XMD435643PAY Allopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine

No ID Information.


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