Provider Demographics
NPI:1306911979
Name:TALATI, AMITA (MD)
Entity type:Individual
Prefix:DR
First Name:AMITA
Middle Name:
Last Name:TALATI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:2301 E EVESHAM RD
Mailing Address - Street 2:SUITE 108
Mailing Address - City:VOORHEES
Mailing Address - State:NJ
Mailing Address - Zip Code:08043-4501
Mailing Address - Country:US
Mailing Address - Phone:856-770-1300
Mailing Address - Fax:856-770-8331
Practice Address - Street 1:2301 E EVESHAM RD
Practice Address - Street 2:SUITE 108
Practice Address - City:VOORHEES
Practice Address - State:NJ
Practice Address - Zip Code:08043-4501
Practice Address - Country:US
Practice Address - Phone:856-770-1300
Practice Address - Fax:856-770-8331
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJMA0473952084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJC60282Medicare UPIN
NJTA467622Medicare ID - Type Unspecified