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NPI Code Detail

MEDICARE: MRS. TERESA M. DEMARIA TEACHER

MEDICARE: MRS. TERESA M. DEMARIA TEACHER
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
1174400000XSpecialist822413NY

General Provider Information

NPI Number : 1336401801
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. TERESA M. DEMARIA TEACHER
Provider Business Mailing Address
First Line : 6905 11TH AVE
Second Line :
City : BROOKLYN
State : NY
Zip : 11228-1206
Country : US
Telephone Number : 718-619-6539
Fax Number :
Provider Business Practice Location Address
First Line : 111 LIVINGSTON ST STE 1101
Second Line :
City : BROOKLYN
State : NY
Zip : 11201-5068
Country : US
Telephone Number : 718-625-4055
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/11/2012
Last Update Date : 06/11/2012

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