Healthcare Provider Details

I. General information

NPI: 1184408122
Provider Name (Legal Business Name): TEHILLA TEIGMAN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/21/2023
Last Update Date: 08/21/2023
Certification Date: 08/21/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3319 AVENUE N
BROOKLYN NY
11234-2605
US

IV. Provider business mailing address

1513 PRESIDENT ST
BROOKLYN NY
11213-4542
US

V. Phone/Fax

Practice location:
  • Phone: 718-258-3300
  • Fax:
Mailing address:
  • Phone: 832-404-0006
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2251S0007X
TaxonomySports Physical Therapist
License Number051058
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: