Provider Demographics
NPI:1841249927
Name:VANDERLINDE, TERESA MARIE (DO)
Entity type:Individual
Prefix:
First Name:TERESA
Middle Name:MARIE
Last Name:VANDERLINDE
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:TERRI
Other - Middle Name:
Other - Last Name:FRISELLA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:839 CENTRAL AVE STE 1
Mailing Address - Street 2:
Mailing Address - City:DOVER
Mailing Address - State:NH
Mailing Address - Zip Code:03820-2506
Mailing Address - Country:US
Mailing Address - Phone:603-516-0000
Mailing Address - Fax:
Practice Address - Street 1:839 CENTRAL AVE STE 1
Practice Address - Street 2:
Practice Address - City:DOVER
Practice Address - State:NH
Practice Address - Zip Code:03820-2506
Practice Address - Country:US
Practice Address - Phone:603-516-0000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-08
Last Update Date:2008-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME1725207VG0400X
NH10011207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH04Y013156NH01OtherFEDERAL BCBS
NH30010551Medicaid
M-121825OtherCIGNA
NH04Y013156NH01OtherNH BCBS
8475278OtherCIGNA NATIONAL
1170854OtherMAILHANDLERS
ME200723OtherME BCBS
2735310OtherAETNA
M-121825OtherCIGNA
8475278OtherCIGNA NATIONAL