Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080A0000X | Adolescent Medicine | 160377 | NY |
NPI | 1114908274 |
---|---|
Provider Name | Dr. Elyse Teicher |
First Address | Nanuet, NY 10954-5262 |
Second Address | Nanuet, NY 10954-5262 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/11/2005 |
Last Update Date | 08/08/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
01009127 | (05) | NY |
A64938 | (02) | NY |