Provider Demographics
NPI:1558548347
Name:ZEMER, TERESA M (LPN, RN)
Entity Type:Individual
Prefix:MS
First Name:TERESA
Middle Name:M
Last Name:ZEMER
Suffix:
Gender:F
Credentials:LPN, RN
Other - Prefix:MS
Other - First Name:TERESA
Other - Middle Name:M
Other - Last Name:COWEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPN
Mailing Address - Street 1:591 YALE CT
Mailing Address - Street 2:
Mailing Address - City:VICTOR
Mailing Address - State:NY
Mailing Address - Zip Code:14564-9553
Mailing Address - Country:US
Mailing Address - Phone:585-309-2095
Mailing Address - Fax:
Practice Address - Street 1:114 THISTLEDOWN DR
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14617-3021
Practice Address - Country:US
Practice Address - Phone:585-309-2095
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-24
Last Update Date:2019-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY232315-0164W00000X
NY749107163WP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0200XNursing Service ProvidersRegistered NursePediatrics
No164W00000XNursing Service ProvidersLicensed Practical Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02549282Medicaid