Provider Demographics
NPI:1790760619
Name:NOVERAS, TERESITA LORENZO (MD)
Entity Type:Individual
Prefix:DR
First Name:TERESITA
Middle Name:LORENZO
Last Name:NOVERAS
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:209 TUTTERS NCK
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:23185-5123
Mailing Address - Country:US
Mailing Address - Phone:757-253-4462
Mailing Address - Fax:757-253-4084
Practice Address - Street 1:4601 IRONBOUND RD
Practice Address - Street 2:
Practice Address - City:WILLIAMSBURG
Practice Address - State:VA
Practice Address - Zip Code:23188-2648
Practice Address - Country:US
Practice Address - Phone:757-253-4462
Practice Address - Fax:757-253-4084
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-12-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA01010357742084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry