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General NPI Number Information
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NPI Number | 1104922640
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Entity Type | Individual
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Provider Name | IRA A TEPLER MD
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Gender | Male
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Dates
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Enumeration Date | 09/15/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 3333 HENRY HUDSON PKWY STE 1
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City | BRONX
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State | NY
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Zip | 10463
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Country | US
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Telephone | 718-796-1000
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Fax | 718-796-2124
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Provider Business Mailing Address
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Address Line | 3333 HENRY HUDSON PKWY WHITEHALL PROFESSIONAL CENTER STE 1
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City | RIVERDALE
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State | NY
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Zip | 10463
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Country | US
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Telephone | 718-796-1000
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Fax | 718-796-2124
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number | 193285
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License Number State | NY
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