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NPI Code Detail

MEDICARE: TERESA PHARMACY INC.

MEDICARE: TERESA PHARMACY INC.
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
13336C0003XCommunity/Retail Pharmacy030873NY

General Provider Information

NPI Number : 1710260195
Entity Type Code : Organization
Provider Name (Legal Business Name) : TERESA PHARMACY INC.
Provider Business Mailing Address
First Line : 582 ROCKAWAY AVE
Second Line :
City : BROOKLYN
State : NY
Zip : 11212-5625
Country : US
Telephone Number : 718-342-3446
Fax Number : 718-342-3448
Provider Business Practice Location Address
First Line : 582 ROCKAWAY AVE
Second Line :
City : BROOKLYN
State : NY
Zip : 11212-5625
Country : US
Telephone Number : 718-342-3446
Fax Number : 718-342-3448
Authorized Official
Title or Position : PRESIDENT
Name : BALJIT KAUR
Credential :
Telephone Number : 718-342-3446
Provider Enumeration Date : 09/22/2011
Last Update Date : 01/24/2012

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