1932285780 NPI number — TIMOTHY HILL CHILDREN'S RANCH

Table of content: JOSETTE ANNA TEUSCHER MD (NPI 1619069168)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1932285780 NPI number — TIMOTHY HILL CHILDREN'S RANCH

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
TIMOTHY HILL CHILDREN'S RANCH
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1932285780
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/21/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
298 MIDDLE RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
RIVERHEAD
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
11901-2034
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
631-369-1402
Provider Business Mailing Address Fax Number:
631-369-0130

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
298 MIDDLE RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
RIVERHEAD
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
11901-2034
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
631-369-1402
Provider Business Practice Location Address Fax Number:
631-369-0130
Provider Enumeration Date:
10/27/2006

Additional Information

Authorized Official

Authorized Official Last Name:
GILDEA
Authorized Official First Name:
BERNADETTE
Authorized Official Middle Name:
Authorized Official Title or Position:
CLINICAL DIRECTOR
Authorized Official Telephone Number:
631-369-1402

Provider Taxonomy Codes

  • Taxonomy code: 251V00000X , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2025 www.npivalidator.com