Provider Demographics
NPI:1568630531
Name:FENOGLIETTO, TALIA J (DC)
Entity type:Individual
Prefix:DR
First Name:TALIA
Middle Name:J
Last Name:FENOGLIETTO
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:225 S FRANKLIN ST
Mailing Address - Street 2:
Mailing Address - City:HOLBROOK
Mailing Address - State:MA
Mailing Address - Zip Code:02343-1455
Mailing Address - Country:US
Mailing Address - Phone:781-767-5555
Mailing Address - Fax:781-767-9751
Practice Address - Street 1:225 S FRANKLIN ST
Practice Address - Street 2:
Practice Address - City:HOLBROOK
Practice Address - State:MA
Practice Address - Zip Code:02343-1455
Practice Address - Country:US
Practice Address - Phone:781-767-5555
Practice Address - Fax:781-767-9751
Is Sole Proprietor?:No
Enumeration Date:2008-02-13
Last Update Date:2008-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIDCP00565111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor