Provider Demographics
NPI:1356039283
Name:TEREBELO, ESTHER (CAS)
Entity type:Individual
Prefix:
First Name:ESTHER
Middle Name:
Last Name:TEREBELO
Suffix:
Gender:F
Credentials:CAS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 NEAL ST
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:NJ
Mailing Address - Zip Code:08527-1201
Mailing Address - Country:US
Mailing Address - Phone:732-299-5897
Mailing Address - Fax:
Practice Address - Street 1:2 NEAL ST
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:NJ
Practice Address - Zip Code:08527-1201
Practice Address - Country:US
Practice Address - Phone:732-299-5897
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-27
Last Update Date:2023-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJCAS238208522080P0006X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0006XAllopathic & Osteopathic PhysiciansPediatricsDevelopmental - Behavioral Pediatrics