Michelle Maria Taclob, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

25MA09036900 Issued in NJ

Practice address

100 Main St
Paterson, NJ 07505-1024

Phone

(973) 523-0317

Fax

(973) 684-8590

NPI assigned

Jul 11, 2008

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NJ

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1215734400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1333065600000",
    "number": "1619131398",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 MAIN ST",
            "city": "PATERSON",
            "state": "NJ",
            "postal_code": "075051024",
            "telephone_number": "973-523-0317"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 MAIN ST",
            "city": "PATERSON",
            "state": "NJ",
            "postal_code": "075051024",
            "telephone_number": "973-523-0317",
            "fax_number": "973-684-8590"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TACLOB",
        "first_name": "MICHELLE",
        "middle_name": "MARIA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-07-11",
        "last_updated": "2012-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NJ",
            "license": "25MA09036900",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "25MA09036900",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Synergy Orthopedics & Spine
• Emily Szczech, DO
• Caroline Szpalski, MD PHD
• Erlinda V Taclob, M.D.
• Lowell T Taclob, M.D.
• Reza Taher, MD
• Radhika Tailor
• Shani Tal, MD
• Marwan Tamimi, DO
• Ramon Tantalean, PHARM. D.

• Internal Medicine Physician in Paterson, NJ
• Providers in Paterson, NJ by specialty
• Internal Medicine Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.