Healthcare Provider Details

I. General information

NPI: 1346269636
Provider Name (Legal Business Name): TERESA CUADRA MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/18/2006
Last Update Date: 12/01/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

275 7TH AVE FL 4
NEW YORK NY
10001-6757
US

IV. Provider business mailing address

280 HENRY STREET BETANCES HEALTH CENTER
NEW YORK NY
10002
US

V. Phone/Fax

Practice location:
  • Phone: 212-924-2510
  • Fax: 212-812-3800
Mailing address:
  • Phone: 212-227-8401
  • Fax: 212-227-8842

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QA0505X
TaxonomyAdult Medicine Physician
License Number169911
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: