Provider Demographics
NPI:1841286747
Name:CHAU, TERESA P (MD)
Entity type:Individual
Prefix:
First Name:TERESA
Middle Name:P
Last Name:CHAU
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 1:2875 UNION RD
Mailing Address - Street 2:SUITE 8
Mailing Address - City:CHEEKTOWAGA
Mailing Address - State:NY
Mailing Address - Zip Code:14227-1465
Mailing Address - Country:US
Mailing Address - Phone:716-651-0911
Mailing Address - Fax:716-651-9855
Practice Address - Street 1:7264 NASH RD
Practice Address - Street 2:
Practice Address - City:NORTH TONAWANDA
Practice Address - State:NY
Practice Address - Zip Code:14120-1508
Practice Address - Country:US
Practice Address - Phone:716-694-7700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-09-26
Last Update Date:2014-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY169818207RG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00010029005OtherUNIVERA
000501670008OtherBCBS
NY000501670007OtherBC/BS
00010029006OtherUNIVERA
NY01075727Medicaid
NY151078BJOtherPREFERRED CARE
NY040426002658OtherFIDELIS
NY0409614OtherIHA
NY000501670007OtherBC/BS
B71091Medicare UPIN
NY01075727Medicaid
P00352573Medicare PIN