Provider Demographics
NPI:1962726968
Name:SHWER, TALIA NICOL (DPM)
Entity type:Individual
Prefix:DR
First Name:TALIA
Middle Name:NICOL
Last Name:SHWER
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4683 MERRICK RD
Mailing Address - Street 2:
Mailing Address - City:MASSAPEQUA
Mailing Address - State:NY
Mailing Address - Zip Code:11758-6021
Mailing Address - Country:US
Mailing Address - Phone:516-799-2525
Mailing Address - Fax:516-799-0015
Practice Address - Street 1:4683 MERRICK RD
Practice Address - Street 2:
Practice Address - City:MASSAPEQUA
Practice Address - State:NY
Practice Address - Zip Code:11758-6021
Practice Address - Country:US
Practice Address - Phone:516-799-2525
Practice Address - Fax:516-799-0015
Is Sole Proprietor?:No
Enumeration Date:2010-03-19
Last Update Date:2014-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYN006513-1213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist