Provider Demographics
NPI:1013130608
Name:TELEM, DEBORAH (CRNP)
Entity type:Individual
Prefix:MS
First Name:DEBORAH
Middle Name:
Last Name:TELEM
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6 LEEWARD DR
Mailing Address - Street 2:
Mailing Address - City:HAVERSTRAW
Mailing Address - State:NY
Mailing Address - Zip Code:10927-2105
Mailing Address - Country:US
Mailing Address - Phone:410-984-3566
Mailing Address - Fax:845-353-1987
Practice Address - Street 1:258 HIGH AVE
Practice Address - Street 2:
Practice Address - City:NYACK
Practice Address - State:NY
Practice Address - Zip Code:10960-2407
Practice Address - Country:US
Practice Address - Phone:845-353-1441
Practice Address - Fax:845-353-1987
Is Sole Proprietor?:No
Enumeration Date:2007-04-11
Last Update Date:2018-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR119712363LX0001X, 363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
No363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & Gynecology