Provider Demographics
NPI:1992011795
Name:HEIGL, TERRA A
Entity Type:Individual
Prefix:
First Name:TERRA
Middle Name:A
Last Name:HEIGL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1000 ELMWOOD AVE STE 500
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14620-3043
Mailing Address - Country:US
Mailing Address - Phone:585-271-0660
Mailing Address - Fax:
Practice Address - Street 1:1000 ELMWOOD AVE STE 500
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14620-3043
Practice Address - Country:US
Practice Address - Phone:585-271-0660
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-08-31
Last Update Date:2010-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator