Individual provider · Type 1 NPI
Johanna D. Tarallo, ANP
Psychiatric/Mental Health Nurse Practitioner · Syracuse, NY
NPI number
1164561536
Active
Practice location
4914 W Seneca Tpke
Syracuse, NY 13215-2225
Fax (315) 469-1742
Mailing address
1210 Euclid Ave
Syracuse, NY 13210-2610
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Psychiatric/Mental Health Nurse Practitioner Primary | 363LP0808X | F301648 (NY) |
Psychiatric/Mental Health Nurse Practitioner: Definition to come...
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About NPI 1164561536
Johanna D. Tarallo, ANP's National Provider Identifier is 1164561536, issued on Feb 5, 2007. The primary taxonomy on file is Psychiatric/Mental Health Nurse Practitioner (363LP0808X), and the practice location is in Syracuse, NY. The record was last updated on Jul 8, 2007.