Provider Demographics
NPI:1174683742
Name:TEPLITZ, ELLEN DONNA (MD)
Entity type:Individual
Prefix:DR
First Name:ELLEN
Middle Name:DONNA
Last Name:TEPLITZ
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Gender:F
Credentials:MD
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Mailing Address - Street 1:1 ELM STREET PARKWAY PLAZA MEDICAL CENTER
Mailing Address - Street 2:SUITE 2B
Mailing Address - City:TUCKAHOE
Mailing Address - State:NY
Mailing Address - Zip Code:10707
Mailing Address - Country:US
Mailing Address - Phone:914-337-9100
Mailing Address - Fax:914-337-9485
Practice Address - Street 1:1 ELM STREET PARKWAY PLAZA MEDICAL CENTER
Practice Address - Street 2:SUITE 2B
Practice Address - City:TUCKAHOE
Practice Address - State:NY
Practice Address - Zip Code:10707
Practice Address - Country:US
Practice Address - Phone:914-337-9100
Practice Address - Fax:914-337-9485
Is Sole Proprietor?:No
Enumeration Date:2006-12-12
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
NY1564121207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
A64895Medicare UPIN
NY93D731Medicare ID - Type Unspecified