Provider Demographics
NPI:1629330204
Name:GILL-PURR, THERESA ANN
Entity Type:Individual
Prefix:MRS
First Name:THERESA
Middle Name:ANN
Last Name:GILL-PURR
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:TERRY
Other - Middle Name:
Other - Last Name:PURR
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:322 CEDARWOOD HALL
Mailing Address - Street 2:BUSINESS OFFICE
Mailing Address - City:VAHALLA
Mailing Address - State:NY
Mailing Address - Zip Code:10595-4614
Mailing Address - Country:US
Mailing Address - Phone:914-493-8719
Mailing Address - Fax:914-493-8066
Practice Address - Street 1:322 CEDARWOOD HALL
Practice Address - Street 2:BUSINESS OFFICE
Practice Address - City:VAHALLA
Practice Address - State:NY
Practice Address - Zip Code:10595
Practice Address - Country:US
Practice Address - Phone:914-493-1343
Practice Address - Fax:914-493-8066
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-11
Last Update Date:2012-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator