Provider Demographics
NPI:1093786485
Name:TE, JAIME C (MD)
Entity Type:Individual
Prefix:MR
First Name:JAIME
Middle Name:C
Last Name:TE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:581 CHESTNUT ST
Mailing Address - Street 2:
Mailing Address - City:CEDARHURST
Mailing Address - State:NY
Mailing Address - Zip Code:11516-2223
Mailing Address - Country:US
Mailing Address - Phone:516-569-2828
Mailing Address - Fax:516-295-4145
Practice Address - Street 1:581 CHESTNUT ST
Practice Address - Street 2:
Practice Address - City:CEDARHURST
Practice Address - State:NY
Practice Address - Zip Code:11516-2223
Practice Address - Country:US
Practice Address - Phone:516-569-2828
Practice Address - Fax:516-295-4145
Is Sole Proprietor?:No
Enumeration Date:2006-02-01
Last Update Date:2008-03-14
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY149701208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01087205Medicaid
NYB02604Medicare UPIN
NY01087205Medicaid
NY13D591Medicare PIN