Provider Demographics
NPI:1821147455
Name:IMPERIALE-WESTERFIELD, TERESA MARIA (FNP)
Entity Type:Individual
Prefix:
First Name:TERESA
Middle Name:MARIA
Last Name:IMPERIALE-WESTERFIELD
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3516 PENINSULA CIR
Mailing Address - Street 2:
Mailing Address - City:MELBOURNE
Mailing Address - State:FL
Mailing Address - Zip Code:32940-1111
Mailing Address - Country:US
Mailing Address - Phone:845-430-2628
Mailing Address - Fax:
Practice Address - Street 1:1344 S APOLLO BLVD
Practice Address - Street 2:
Practice Address - City:MELBOURNE
Practice Address - State:FL
Practice Address - Zip Code:32901-3183
Practice Address - Country:US
Practice Address - Phone:321-724-1084
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-10
Last Update Date:2020-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF3332611363L00000X
FLARNP 9408062363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY110559500OtherUS DEPARTMENT OF LABOR
R39623Medicare UPIN
NYA400008485Medicare PIN