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General NPI Number Information
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NPI Number | 1669530788
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Entity Type | Individual
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Provider Name | MICHAEL ANGELO TERESE RN
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Gender | Male
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Dates
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Enumeration Date | 12/04/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 2250 WEHRLE DR SUITE 1
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City | WILLIAMSVILLE
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State | NY
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Zip | 14221-7037
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Country | US
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Telephone | 716-276-2123
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Fax | 716-276-2129
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Provider Business Mailing Address
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Address Line | 60 PENNSYLVANIA AVE APT 7
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City | DUNKIRK
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State | NY
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Zip | 14048-3405
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Country | US
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Telephone | 716-366-5774
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Fax |
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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 | 163WH0200X
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Taxonomy Name | Home Health Registered Nurse
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License Number | 466371-1
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License Number State | NY
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