Provider Demographics
NPI:1235864331
Name:RICHARD C TETER, DPM, PLLC
Entity Type:Organization
Organization Name:RICHARD C TETER, DPM, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:
Authorized Official - Last Name:TETER
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:212-434-2000
Mailing Address - Street 1:930 5TH AVE APT 1E
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10021-2680
Mailing Address - Country:US
Mailing Address - Phone:917-310-1963
Mailing Address - Fax:
Practice Address - Street 1:930 5TH AVE APT 1E
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10021-2680
Practice Address - Country:US
Practice Address - Phone:917-310-1963
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-07-21
Last Update Date:2022-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0000XPodiatric Medicine & Surgery Service ProvidersPodiatristSports MedicineGroup - Single Specialty