Provider Demographics
NPI:1245804897
Name:TEYTELMAN, LANI (MD)
Entity type:Individual
Prefix:DR
First Name:LANI
Middle Name:
Last Name:TEYTELMAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1909 QUENTIN RD APT 6B
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11229-2352
Mailing Address - Country:US
Mailing Address - Phone:718-415-5776
Mailing Address - Fax:
Practice Address - Street 1:1909 QUENTIN RD
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11229-2370
Practice Address - Country:US
Practice Address - Phone:718-415-5776
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-18
Last Update Date:2021-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program