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General NPI Number Information
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NPI Number | 1245390442
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Entity Type | Organization
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Legal Business Name | MARVIN L TEICH MD
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Dates
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Enumeration Date | 12/11/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 665 THWAITES PL
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City | BRONX
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State | NY
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Zip | 10467-7947
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Country | US
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Telephone | 718-882-3500
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 302
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City | RYE
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State | NY
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Zip | 10580-0302
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | SOLE PROPRIETOR
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Name | MARVIN L TEICH
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Credential |
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Telephone | 718-882-3500
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 173000000X
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Taxonomy Name | Legal Medicine
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License Number | 096234
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License Number State | NY
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