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1164561536
JOHANNA D TARALLO
SYRACUSE, NY
NPI
1164561536
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
363LP0808X Nurse Practitioner, Psych/Mental Health
(Licence: NY F301648)
Enumeration Date
2007-02-05
Last Update Date
2007-07-08
Business Address
Ms. JOHANNA D TARALLO ANP
4914 W SENECA TPKE
SYRACUSE, NY 13215-2225
Phone number: 315-468-2827
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Mailing Address
Ms. JOHANNA D TARALLO ANP
1210 EUCLID AVE
SYRACUSE, NY 13210-2610
Phone number: 315-474-2439
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