Provider Demographics
NPI:1669091716
Name:TALLAJ, YINABETH
Entity type:Individual
Prefix:
First Name:YINABETH
Middle Name:
Last Name:TALLAJ
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 1:571 ACADEMY ST APT 1A
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10034-5105
Mailing Address - Country:US
Mailing Address - Phone:833-717-2828
Mailing Address - Fax:347-625-6551
Practice Address - Street 1:610 ACADEMY ST STE 10A
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10034-5058
Practice Address - Country:US
Practice Address - Phone:833-717-2828
Practice Address - Fax:347-625-6551
Is Sole Proprietor?:No
Enumeration Date:2020-04-09
Last Update Date:2025-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY333094207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine