Provider Demographics
NPI:1104831551
Name:TERWES, ESTELLA (MD)
Entity Type:Individual
Prefix:DR
First Name:ESTELLA
Middle Name:
Last Name:TERWES
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 1:906 SUMMIT AVE
Mailing Address - Street 2:GROUND FLOOR
Mailing Address - City:JERSEY CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:07307-3714
Mailing Address - Country:US
Mailing Address - Phone:201-653-0330
Mailing Address - Fax:
Practice Address - Street 1:906 SUMMIT AVE
Practice Address - Street 2:GROUND FLOOR
Practice Address - City:JERSEY CITY
Practice Address - State:NJ
Practice Address - Zip Code:07307-3714
Practice Address - Country:US
Practice Address - Phone:201-653-0330
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-31
Last Update Date:2008-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA04873400208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0551902Medicaid
NJ0551902Medicaid
NJ443975Medicare ID - Type Unspecified