Provider Demographics
NPI:1013120674
Name:CILIBERTI, THERESA S (NP)
Entity Type:Individual
Prefix:MS
First Name:THERESA
Middle Name:S
Last Name:CILIBERTI
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1320 YORK AVE APT 23Q
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10021-4866
Mailing Address - Country:US
Mailing Address - Phone:917-952-5233
Mailing Address - Fax:
Practice Address - Street 1:CRMI
Practice Address - Street 2:1305 YORK AVENUE 6TH FLOOR
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10021-4866
Practice Address - Country:US
Practice Address - Phone:917-952-5233
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF420799-1363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health