Provider Demographics
NPI:1073685095
Name:TERAGUCHI, KARI JANE (MD)
Entity Type:Individual
Prefix:DR
First Name:KARI
Middle Name:JANE
Last Name:TERAGUCHI
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 1:3196 KENNEDY BLVD
Mailing Address - Street 2:
Mailing Address - City:UNION CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:07087-2436
Mailing Address - Country:US
Mailing Address - Phone:201-319-9800
Mailing Address - Fax:201-319-9849
Practice Address - Street 1:3196 KENNEDY BLVD
Practice Address - Street 2:
Practice Address - City:UNION CITY
Practice Address - State:NJ
Practice Address - Zip Code:07087-2436
Practice Address - Country:US
Practice Address - Phone:201-319-9800
Practice Address - Fax:201-319-9849
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-14
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY214610208000000X
NJ25MA07829800208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ25MA07829800OtherSTATE OF NEW JERSEY
NY214610OtherSTATE MEDICAL LICENSE NUM
NJFT1328776OtherDEA