Provider Demographics
NPI:1043203656
Name:TEICHMAN, ADAM JAY (DPM)
Entity Type:Individual
Prefix:DR
First Name:ADAM
Middle Name:JAY
Last Name:TEICHMAN
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2895 HAMILTON BLVD STE 101
Mailing Address - Street 2:
Mailing Address - City:ALLENTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18104-6172
Mailing Address - Country:US
Mailing Address - Phone:610-330-9740
Mailing Address - Fax:610-432-4887
Practice Address - Street 1:2895 HAMILTON BLVD STE 101
Practice Address - Street 2:
Practice Address - City:ALLENTOWN
Practice Address - State:PA
Practice Address - Zip Code:18104-6172
Practice Address - Country:US
Practice Address - Phone:610-330-9740
Practice Address - Fax:610-432-4887
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-30
Last Update Date:2020-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASC005850213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAP00388796OtherRRB - MEDICARE RAILROAD
PA1013597540004Medicaid
PAP00388796OtherRRB - MEDICARE RAILROAD
PA1013597540004Medicaid
PA092725LXXMedicare PIN