Provider Demographics
NPI:1184966350
Name:ALEJANDRO, TERESITA E (REGISTERED NURSE)
Entity type:Individual
Prefix:
First Name:TERESITA
Middle Name:E
Last Name:ALEJANDRO
Suffix:
Gender:F
Credentials:REGISTERED NURSE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:241 W PASSAIC ST APT 2A
Mailing Address - Street 2:
Mailing Address - City:ROCHELLE PARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07662-3115
Mailing Address - Country:US
Mailing Address - Phone:201-214-6236
Mailing Address - Fax:
Practice Address - Street 1:241 W PASSAIC ST APT 2A
Practice Address - Street 2:
Practice Address - City:ROCHELLE PARK
Practice Address - State:NJ
Practice Address - Zip Code:07662-3115
Practice Address - Country:US
Practice Address - Phone:201-214-6236
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-26
Last Update Date:2013-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY536452-1163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY536542-1OtherNEW YORK EDUCATION DEPARTMENT