Provider Demographics
NPI:1679558860
Name:TALMA, RUSSELL CLARENCE (PA-C)
Entity type:Individual
Prefix:MR
First Name:RUSSELL
Middle Name:CLARENCE
Last Name:TALMA
Suffix:
Gender:M
Credentials:PA-C
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Mailing Address - Street 1:6698 MACINTOSH LN
Mailing Address - Street 2:
Mailing Address - City:N TONAWANDA
Mailing Address - State:NY
Mailing Address - Zip Code:14120-9648
Mailing Address - Country:US
Mailing Address - Phone:716-210-3043
Mailing Address - Fax:716-862-8600
Practice Address - Street 1:3495 BAILEY AVE
Practice Address - Street 2:VA MEDICAL CENTER. DEPT OF SURGERY
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14215-1129
Practice Address - Country:US
Practice Address - Phone:716-862-8500
Practice Address - Fax:716-862-8600
Is Sole Proprietor?:No
Enumeration Date:2005-12-09
Last Update Date:2013-05-06
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY007105363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant