| Doctor Name: | LORI L TEAKEN |
| NPI Number: | 1689070070 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PT |
| License Number: | 036834-1 |
| Business Practice Address: | 358 Madison St Waterville, NY - 134801116 |
| Business Phone Number: | 3158413222 |
| Business Fax Number: | 3158414023 |
| Mailing Address: | 792 N Main St, Suite 100c NORTH SYRACUSE |
| State: | NY |
| Postal Code: | 132121644 |
| Phone Number: | 3154582552 |
| Fax Number: | 3154582575 |
| NPI Enumeration Date: | 11/12/2014 |
| NPI Last Update Date: | 04/16/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 225100000X |
| License Number: | 036834-1 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NY |
| Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Taxonomy Classification: | Physical Therapist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT |