Healthcare Provider Details

I. General information

NPI: 1487572830
Provider Name (Legal Business Name): TERESA LYNN ENGERT RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/06/2026
Last Update Date: 07/06/2026
Certification Date: 07/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2006 MADISON AVE
NEW YORK NY
10035-1217
US

IV. Provider business mailing address

PO BOX 37 653 COLGATE RD.
EAST JEWETT NY
12424-0037
US

V. Phone/Fax

Practice location:
  • Phone: 347-809-0327
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP2201X
TaxonomyAmbulatory Care Registered Nurse
License Number661889
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: