Provider Demographics
NPI:1720014582
Name:LITCHFIELD, TERESA H (DC)
Entity Type:Individual
Prefix:
First Name:TERESA
Middle Name:H
Last Name:LITCHFIELD
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 381
Mailing Address - Street 2:
Mailing Address - City:ANDOVER
Mailing Address - State:NJ
Mailing Address - Zip Code:07821-0381
Mailing Address - Country:US
Mailing Address - Phone:973-579-1921
Mailing Address - Fax:973-579-7026
Practice Address - Street 1:527 RT 206
Practice Address - Street 2:
Practice Address - City:NEWTON
Practice Address - State:NJ
Practice Address - Zip Code:07860
Practice Address - Country:US
Practice Address - Phone:973-579-1921
Practice Address - Fax:973-579-7026
Is Sole Proprietor?:No
Enumeration Date:2006-06-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00206800111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ1129971Medicaid
NJ5101566Medicare ID - Type Unspecified