Provider Demographics
NPI:1235260134
Name:TEYTEL, JANNA L (OD)
Entity Type:Individual
Prefix:DR
First Name:JANNA
Middle Name:L
Last Name:TEYTEL
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:75 CHESTNUT ST
Mailing Address - Street 2:
Mailing Address - City:LIVINGSTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07039-5514
Mailing Address - Country:US
Mailing Address - Phone:973-597-0959
Mailing Address - Fax:
Practice Address - Street 1:52 DEFOREST AVE
Practice Address - Street 2:
Practice Address - City:SUMMIT
Practice Address - State:NJ
Practice Address - Zip Code:07901-1930
Practice Address - Country:US
Practice Address - Phone:908-277-3116
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY27OA00596600152WV0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152WV0400XEye and Vision Services ProvidersOptometristVision Therapy