1346248200 NPI number — DR. ROBERT PHILLIP TEPLEY PH.D

Table of content: DR. ROBERT PHILLIP TEPLEY PH.D (NPI 1346248200)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1346248200 NPI number — DR. ROBERT PHILLIP TEPLEY PH.D

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
TEPLEY
Provider First Name:
ROBERT
Provider Middle Name:
PHILLIP
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
PH.D
Provider Gender Code:
M

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:
1346248200
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
111 EAST AVE
Provider Second Line Business Mailing Address:
SUITE 313
Provider Business Mailing Address City Name:
NORWALK
Provider Business Mailing Address State Name:
CT
Provider Business Mailing Address Postal Code:
06851-5014
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
203-855-9691
Provider Business Mailing Address Fax Number:
203-855-7743

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
111 EAST AVE
Provider Second Line Business Practice Location Address:
SUITE 313
Provider Business Practice Location Address City Name:
NORWALK
Provider Business Practice Location Address State Name:
CT
Provider Business Practice Location Address Postal Code:
06851-5014
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
203-855-9691
Provider Business Practice Location Address Fax Number:
203-855-7743
Provider Enumeration Date:
07/13/2005

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 103G00000X , with the licence number:  002279 , registered in the state of CT ; information, associated with the NPI states the following Primary Taxonomy Switch: "X" .
  • Taxonomy code: 103TR0400X , with the licence number: 002279 , registered in the state of CT ; information, associated with the NPI states the following Primary Taxonomy Switch: "X" .

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





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