Provider Demographics
NPI:1720241789
Name:TEELIN, KAREN LEWINNEK (MD)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:LEWINNEK
Last Name:TEELIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:KAREN
Other - Middle Name:ANN
Other - Last Name:LEWINNEK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:725 EAST ADAMS ST
Mailing Address - Street 2:4TH FL
Mailing Address - City:SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13210
Mailing Address - Country:US
Mailing Address - Phone:315-464-5831
Mailing Address - Fax:315-464-2030
Practice Address - Street 1:725 EAST ADAMS ST
Practice Address - Street 2:4TH FL
Practice Address - City:SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13210
Practice Address - Country:US
Practice Address - Phone:315-464-5831
Practice Address - Fax:315-464-2030
Is Sole Proprietor?:No
Enumeration Date:2008-07-09
Last Update Date:2023-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY259683-1208000000X
NY390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY03424953Medicaid
NYJ400063956Medicare PIN
NY03424953Medicaid