Provider Demographics
NPI:1467571943
Name:ERIC S TEITEL MD PC
Entity Type:Organization
Organization Name:ERIC S TEITEL MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:GABRIELLE
Authorized Official - Middle Name:A
Authorized Official - Last Name:CASTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:914-734-8224
Mailing Address - Street 1:1985 CROMPOND RD UPPR E
Mailing Address - Street 2:
Mailing Address - City:CORTLANDT MANOR
Mailing Address - State:NY
Mailing Address - Zip Code:10567-4146
Mailing Address - Country:US
Mailing Address - Phone:914-734-8224
Mailing Address - Fax:
Practice Address - Street 1:1985 CROMPOND RD UPPR E
Practice Address - Street 2:
Practice Address - City:CORTLANDT MANOR
Practice Address - State:NY
Practice Address - Zip Code:10567-4146
Practice Address - Country:US
Practice Address - Phone:914-734-8224
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-28
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY142956174400000X
NY201455174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty