Provider Demographics
NPI:1376643981
Name:SUAREZ, TERESA (MD)
Entity Type:Individual
Prefix:
First Name:TERESA
Middle Name:
Last Name:SUAREZ
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 1:473 SYLVAN AVE
Mailing Address - Street 2:
Mailing Address - City:ENGLEWOOD CLIFFS
Mailing Address - State:NJ
Mailing Address - Zip Code:07632-2918
Mailing Address - Country:US
Mailing Address - Phone:201-569-5151
Mailing Address - Fax:201-569-9193
Practice Address - Street 1:473 SYLVAN AVE
Practice Address - Street 2:
Practice Address - City:ENGLEWOOD CLIFFS
Practice Address - State:NJ
Practice Address - Zip Code:07632-2918
Practice Address - Country:US
Practice Address - Phone:201-569-5151
Practice Address - Fax:201-569-9193
Is Sole Proprietor?:No
Enumeration Date:2006-09-24
Last Update Date:2007-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA04060000207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ522005CCSOtherPROVIDER IDENTIFIER
NJ522005CCSOtherPROVIDER IDENTIFIER