Healthcare Provider Details
I. General information
NPI: 1922268168
Provider Name (Legal Business Name): TERESA L MAY DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 06/11/2008
Last Update Date: 01/10/2017
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
100 FODEN RD SUITE 103, WEST BUILDING
SOUTH PORTLAND ME
04106-2327
US
IV. Provider business mailing address
710 W 168TH ST
NEW YORK NY
10032-3726
US
V. Phone/Fax
- Phone: 207-828-1122
- Fax: 208-828-0188
- Phone: 212-305-7236
- Fax: 212-305-2792
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207RC0200X |
| Taxonomy | Critical Care Medicine (Internal Medicine) Physician |
| License Number | 274461 |
| License Number State | NY |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207RP1001X |
| Taxonomy | Pulmonary Disease Physician |
| License Number | DO2185 |
| License Number State | ME |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: