Provider Demographics
NPI:1710214499
Name:PINCUS, TERESA M (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:TERESA
Middle Name:M
Last Name:PINCUS
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:MS
Other - First Name:TERESA
Other - Middle Name:M
Other - Last Name:ENDICOTT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:730 SHORE RD
Mailing Address - Street 2:
Mailing Address - City:SOMERS POINT
Mailing Address - State:NJ
Mailing Address - Zip Code:08244-2331
Mailing Address - Country:US
Mailing Address - Phone:609-927-6662
Mailing Address - Fax:609-927-2942
Practice Address - Street 1:730 SHORE RD
Practice Address - Street 2:
Practice Address - City:SOMERS POINT
Practice Address - State:NJ
Practice Address - Zip Code:08244-2331
Practice Address - Country:US
Practice Address - Phone:609-927-6662
Practice Address - Fax:609-927-2942
Is Sole Proprietor?:No
Enumeration Date:2009-11-17
Last Update Date:2015-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MP00229300363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical