| Doctor Name: | EDWARD DAVID TELLER |
| NPI Number: | 1659413201 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | MD |
| License Number: | 140188 |
| Business Practice Address: | 466 Main Street New Rochelle, NY - 10801 |
| Business Phone Number: | 9146331020 |
| Business Fax Number: | 9146333235 |
| Mailing Address: | 215 Winding Brook Rd, NEW ROCHELLE |
| State: | NY |
| Postal Code: | 10804 |
| Phone Number: | 9147404272 |
| Fax Number: | 9145763689 |
| NPI Enumeration Date: | 02/12/2007 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | 140188 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NY |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |