Provider Demographics
NPI:1245349752
Name:TEUSCHER, ENRIQUE J (MD)
Entity type:Individual
Prefix:
First Name:ENRIQUE
Middle Name:J
Last Name:TEUSCHER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:47 STONELEA PL
Mailing Address - Street 2:
Mailing Address - City:NEW ROCHELLE
Mailing Address - State:NY
Mailing Address - Zip Code:10801-4506
Mailing Address - Country:US
Mailing Address - Phone:914-576-1318
Mailing Address - Fax:914-576-1510
Practice Address - Street 1:47 STONELEA PL
Practice Address - Street 2:
Practice Address - City:NEW ROCHELLE
Practice Address - State:NY
Practice Address - Zip Code:10801-4506
Practice Address - Country:US
Practice Address - Phone:914-576-1318
Practice Address - Fax:914-576-1510
Is Sole Proprietor?:No
Enumeration Date:2006-08-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1268292084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00765628Medicaid
NY95A27100Medicare ID - Type Unspecified
B20288Medicare UPIN