1871578450 NPI number — DR. ARIEL DAN TEITEL MD

Table of content: DR. ARIEL DAN TEITEL MD (NPI 1871578450)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1871578450 NPI number — DR. ARIEL DAN TEITEL MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
TEITEL
Provider First Name:
ARIEL
Provider Middle Name:
DAN
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
MD
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:
1871578450
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/17/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
26 W 38TH ST
Provider Second Line Business Mailing Address:
6TH FLOOR
Provider Business Mailing Address City Name:
NEW YORK
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
10018-6276
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
212-221-7971
Provider Business Mailing Address Fax Number:
212-221-7973

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
37 W 26TH ST
Provider Second Line Business Practice Location Address:
SUITE 204
Provider Business Practice Location Address City Name:
NEW YORK
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
10010-1006
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
212-221-7971
Provider Business Practice Location Address Fax Number:
866-546-3236
Provider Enumeration Date:
12/07/2005

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: 207RR0500X , with the licence number:  177768 , 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)

  • Identifier: 01193888 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".




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