Provider Demographics
NPI:1154302032
Name:TELSEY, AIMEE (MD)
Entity Type:Individual
Prefix:
First Name:AIMEE
Middle Name:
Last Name:TELSEY
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:PO BOX 2436
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19147-0436
Mailing Address - Country:US
Mailing Address - Phone:212-420-2944
Mailing Address - Fax:
Practice Address - Street 1:BETH ISRAEL MED CTR
Practice Address - Street 2:DEPT OF PEDIATRICS
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10003
Practice Address - Country:US
Practice Address - Phone:212-420-2944
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-11-08
Last Update Date:2014-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1565821208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00906914Medicaid
A61777Medicare UPIN
NY27E791Medicare ID - Type Unspecified