Healthcare Provider Details
I. General information
NPI: 1982163184
Provider Name (Legal Business Name): SARAH DOLORES TEITELL MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 03/18/2019
Last Update Date: 07/17/2023
Certification Date: 07/17/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
300 CADMAN PLZ W FL 17
BROOKLYN NY
11201-3229
US
IV. Provider business mailing address
300 CADMAN PLZ W FL 17
BROOKLYN NY
11201-3229
US
V. Phone/Fax
- Phone: 929-210-6000
- Fax: 929-210-6001
- Phone: 929-210-6000
- Fax: 929-210-6001
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208000000X |
| Taxonomy | Pediatrics Physician |
| License Number | 321401 |
| License Number State | NY |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: