Provider Demographics
NPI:1508961822
Name:DAVID TEICHMAN
Entity Type:Organization
Organization Name:DAVID TEICHMAN
Other - Org Name:PARKVIEW PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:TEICHMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:201-837-6368
Mailing Address - Street 1:1430 QUEEN ANNE RD
Mailing Address - Street 2:
Mailing Address - City:TEANECK
Mailing Address - State:NJ
Mailing Address - Zip Code:07666-3518
Mailing Address - Country:US
Mailing Address - Phone:201-837-6368
Mailing Address - Fax:201-837-9363
Practice Address - Street 1:1430 QUEEN ANNE RD
Practice Address - Street 2:
Practice Address - City:TEANECK
Practice Address - State:NJ
Practice Address - Zip Code:07666-3518
Practice Address - Country:US
Practice Address - Phone:201-837-6368
Practice Address - Fax:201-837-9363
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-13
Last Update Date:2011-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
NJ28RS002767003336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
3115575OtherNCPDP PROVIDER IDENTIFICATION NUMBER
NJ4292901Medicaid