Healthcare Provider Details

I. General information

NPI: 1073505376
Provider Name (Legal Business Name): HAROLD GEORGE TEPLER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/22/2005
Last Update Date: 12/09/2021
Certification Date: 12/09/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9225 KENNEDY BLVD SUITE D
NORTH BERGEN NJ
07047-5322
US

IV. Provider business mailing address

8901 KENNEDY BLVD STE 5S
NORTH BERGEN NJ
07047-5345
US

V. Phone/Fax

Practice location:
  • Phone: 201-868-2849
  • Fax: 201-868-4190
Mailing address:
  • Phone: 201-868-2849
  • Fax: 201-868-4190

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License Number25MA07093600
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: