Provider Demographics
NPI:1174651160
Name:NORDEN, TERRI ANN (MD)
Entity Type:Individual
Prefix:DR
First Name:TERRI
Middle Name:ANN
Last Name:NORDEN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:350 CENTRAL PARK W
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10025-6547
Mailing Address - Country:US
Mailing Address - Phone:212-666-3291
Mailing Address - Fax:212-864-9515
Practice Address - Street 1:560 NORTHERN BLVD
Practice Address - Street 2:SUITE 106
Practice Address - City:GREAT NECK
Practice Address - State:NY
Practice Address - Zip Code:11021-5100
Practice Address - Country:US
Practice Address - Phone:516-466-6160
Practice Address - Fax:516-466-7814
Is Sole Proprietor?:No
Enumeration Date:2007-03-01
Last Update Date:2017-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY172563-3208VP0014X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY15G643Medicare UPIN