Provider Demographics
NPI:1033285507
Name:NEUWALDER, TERUKO (MD)
Entity Type:Individual
Prefix:
First Name:TERUKO
Middle Name:
Last Name:NEUWALDER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1600 PARKER AVENUE
Mailing Address - Street 2:APT. 15-G
Mailing Address - City:FT. LEE
Mailing Address - State:NJ
Mailing Address - Zip Code:07024-7006
Mailing Address - Country:US
Mailing Address - Phone:201-569-2120
Mailing Address - Fax:
Practice Address - Street 1:11 E 68TH ST
Practice Address - Street 2:SUITE 1-B
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10021-4955
Practice Address - Country:US
Practice Address - Phone:212-737-0404
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY902362084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry