| Doctor Name: | MRS. TERESA M CONKLIN |
| NPI Number: | 1275769176 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | FNP |
| License Number: | 26NO09584600 |
| Business Practice Address: | 400 S Orange Ave South Orange, NJ - 070792646 |
| Business Phone Number: | 9737619175 |
| Business Fax Number: | |
| Mailing Address: | 18 W Blackwell St, DOVER |
| State: | NJ |
| Postal Code: | 078013841 |
| Phone Number: | |
| Fax Number: | |
| NPI Enumeration Date: | 06/05/2009 |
| NPI Last Update Date: | 07/14/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | 26NO09584600 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NJ |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |