Provider Demographics
NPI:1013083658
Name:TEITELBAUM, NADINE L (PHARMD)
Entity type:Individual
Prefix:DR
First Name:NADINE
Middle Name:L
Last Name:TEITELBAUM
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:95 NEWFIELD AVE
Mailing Address - Street 2:
Mailing Address - City:EDISON
Mailing Address - State:NJ
Mailing Address - Zip Code:08837-3824
Mailing Address - Country:US
Mailing Address - Phone:732-346-1333
Mailing Address - Fax:732-346-1999
Practice Address - Street 1:95 NEWFIELD AVE
Practice Address - Street 2:
Practice Address - City:EDISON
Practice Address - State:NJ
Practice Address - Zip Code:08837-3824
Practice Address - Country:US
Practice Address - Phone:732-346-1333
Practice Address - Fax:732-346-1999
Is Sole Proprietor?:No
Enumeration Date:2006-11-27
Last Update Date:2007-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ2958600183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist