Provider Demographics
NPI:1841987278
Name:TAGLIAFERRI, MADISYN RILEY
Entity type:Individual
Prefix:
First Name:MADISYN
Middle Name:RILEY
Last Name:TAGLIAFERRI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26223 READE PL
Mailing Address - Street 2:
Mailing Address - City:STEVENSON RANCH
Mailing Address - State:CA
Mailing Address - Zip Code:91381-1421
Mailing Address - Country:US
Mailing Address - Phone:661-993-6094
Mailing Address - Fax:
Practice Address - Street 1:4900 SERRANIA AVE
Practice Address - Street 2:
Practice Address - City:WOODLAND HILLS
Practice Address - State:CA
Practice Address - Zip Code:91364-3301
Practice Address - Country:US
Practice Address - Phone:818-347-1577
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-18
Last Update Date:2023-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program