Tali Reeis-Martin Physician PC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

256048 Issued in NY

Legal business name

TALI REEIS-MARTIN PHYSICIAN PC

Practice address

101 Chalburn Rd
Vestal, NY 13850-2880

Phone

(305) 206-3375

NPI assigned

Jun 11, 2013

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Tali Reeis-Martin, MD

Title

Owner

Phone

(305) 206-3375

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1370908800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1370908800000",
    "number": "1376981415",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 GATES RD",
            "address_2": "STE 3",
            "city": "VESTAL",
            "state": "NY",
            "postal_code": "138502288",
            "telephone_number": "607-772-9462",
            "fax_number": "607-772-1223"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 CHALBURN RD",
            "city": "VESTAL",
            "state": "NY",
            "postal_code": "138502880",
            "telephone_number": "305-206-3375"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TALI REEIS-MARTIN PHYSICIAN PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-06-11",
        "last_updated": "2013-06-11",
        "status": "A",
        "authorized_official_last_name": "REEIS-MARTIN",
        "authorized_official_first_name": "TALI",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "305-206-3375",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "256048",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03186629",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Wayne Teris, MD
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• The Pavilion at Vestal, LLC

• Internal Medicine Physician in Vestal, NY
• Providers in Vestal, NY by specialty
• Internal Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.