MEDICARE: TERESA K W NING M.D.

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	207L00000X	Anesthesiology Physician	031977	CT

General Provider Information

NPI Number	:	1841352408
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TERESA K W NING M.D.

Provider Business Mailing Address
First Line	:	690 CANTON ST
Second Line	:	STE 325
City	:	WESTWOOD
State	:	MA
Zip	:	02090-2324
Country	:	US
Telephone Number	:	781-407-7713
Fax Number	:	781-407-0998

Provider Business Practice Location Address
First Line	:	1055 WASHINGTON BLVD
Second Line	:	SUITE 424
City	:	STAMFORD
State	:	CT
Zip	:	06901-2216
Country	:	US
Telephone Number	:	203-348-2614
Fax Number	:	203-325-8677

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/13/2006
Last Update Date	:	04/06/2016

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