Doctor Name: | TERESA RIBADENYRA |
NPI Number: | 1336197979 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PA-C |
License Number: | 177485 |
Business Practice Address: | 710 Stockbridge Rd Lee, MA - 012389316 |
Business Phone Number: | 4132430122 |
Business Fax Number: | 4132432251 |
Mailing Address: | 1556 Route 203, CHATHAM |
State: | NY |
Postal Code: | 120371708 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 05/05/2006 |
NPI Last Update Date: | 01/13/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363AM0700X |
License Number: | 177485 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MA |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Physician Assistant |
Taxonomy Specialization: | Medical |
Taxonomy Definition: |