Provider Demographics
NPI:1205923893
Name:TITELIS, JOANN A (MD)
Entity type:Individual
Prefix:DR
First Name:JOANN
Middle Name:A
Last Name:TITELIS
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5800 3RD AVE
Mailing Address - Street 2:MANAGED CARE DEPARTMENT
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11220-3702
Mailing Address - Country:US
Mailing Address - Phone:718-630-7477
Mailing Address - Fax:718-630-7437
Practice Address - Street 1:220 13TH ST
Practice Address - Street 2:PARK SLOPE FAMILY HEALTH CENTER
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11215-4802
Practice Address - Country:US
Practice Address - Phone:718-832-5980
Practice Address - Fax:718-630-7437
Is Sole Proprietor?:No
Enumeration Date:2006-10-06
Last Update Date:2025-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT055364207VX0000X
NY239888207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VX0000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyObstetrics
No207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology