Provider Demographics
NPI:1982579009
Name:JEFF L TEIBEL DPM FOOT DOCTOR
Entity type:Organization
Organization Name:JEFF L TEIBEL DPM FOOT DOCTOR
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:L
Authorized Official - Last Name:TEIBEL
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:585-721-3668
Mailing Address - Street 1:290 FOREST HILLS RD
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14625-1947
Mailing Address - Country:US
Mailing Address - Phone:585-721-3668
Mailing Address - Fax:585-385-9124
Practice Address - Street 1:85 S UNION ST STE 203
Practice Address - Street 2:
Practice Address - City:SPENCERPORT
Practice Address - State:NY
Practice Address - Zip Code:14559-1264
Practice Address - Country:US
Practice Address - Phone:585-721-3668
Practice Address - Fax:585-385-9124
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-10-08
Last Update Date:2025-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty