Provider Demographics
NPI:1184946956
Name:TERAGRAM I, INC.
Entity type:Organization
Organization Name:TERAGRAM I, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:MARGARET
Authorized Official - Middle Name:S
Authorized Official - Last Name:DERAGO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:516-938-6006
Mailing Address - Street 1:881 BROADWAY MALL
Mailing Address - Street 2:
Mailing Address - City:HICKSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:11801-2712
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:881 BROADWAY MALL
Practice Address - Street 2:
Practice Address - City:HICKSVILLE
Practice Address - State:NY
Practice Address - Zip Code:11801-2712
Practice Address - Country:US
Practice Address - Phone:516-938-6006
Practice Address - Fax:516-938-6018
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-02-22
Last Update Date:2010-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty