Provider Demographics
NPI:1477596179
Name:TENG, MARITA S (MD)
Entity Type:Individual
Prefix:DR
First Name:MARITA
Middle Name:S
Last Name:TENG
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Mailing Address - Street 1:5 EAST 98TH STREET
Mailing Address - Street 2:BOX 1191
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10029
Mailing Address - Country:US
Mailing Address - Phone:212-241-9410
Mailing Address - Fax:212-996-9097
Practice Address - Street 1:5 EAST 98TH STREET
Practice Address - Street 2:8TH FLOOR
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10029
Practice Address - Country:US
Practice Address - Phone:212-241-9410
Practice Address - Fax:212-996-9097
Is Sole Proprietor?:No
Enumeration Date:2006-06-13
Last Update Date:2023-09-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY221169207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY2680037Medicaid
NY02680037Medicaid
NY02680037Medicaid
NY2680037Medicaid
5324VGMedicare PIN