MEDICARE: JEFFREY L. TEITELBAUM, MD PC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208000000X	Pediatrics Physician	188400	NY
2	207R00000X	Internal Medicine Physician	188400	NY

General Provider Information

NPI Number	:	1306937347
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JEFFREY L. TEITELBAUM, MD PC

Provider Business Mailing Address
First Line	:	913 AVENUE L
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11230-4707
Country	:	US
Telephone Number	:	718-859-8391
Fax Number	:

Provider Business Practice Location Address
First Line	:	913 AVENUE L
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11230-4707
Country	:	US
Telephone Number	:	718-859-8391
Fax Number	:

Authorized Official
Title or Position	:	OFFICE MANAGER
Name	:	MISS MALKY TENENBAUM
Credential	:
Telephone Number	:	718-859-8391

Provider Enumeration Date	:	09/27/2006
Last Update Date	:	05/05/2023

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