Healthcare Provider Details

I. General information

NPI: 1932017829
Provider Name (Legal Business Name): ADINA TEITELBAUM
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/31/2026
Last Update Date: 08/31/2026
Certification Date: 08/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3321 AVENUE M
BROOKLYN NY
11210-5421
US

IV. Provider business mailing address

1129 HARRIS AVE
FAR ROCKAWAY NY
11691-4816
US

V. Phone/Fax

Practice location:
  • Phone: 718-531-1800
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: