Doctor Name: | MRS. TERESA MARIE GANDARILLAS |
NPI Number: | 1740527837 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.A. ED. |
License Number: | 803394 |
Business Practice Address: | 538 Broadhollow Rd Suite 202 Melville, NY - 117473676 |
Business Phone Number: | 6313857780 |
Business Fax Number: | 6313857795 |
Mailing Address: | 7 Arlene St, FARMINGVILLE |
State: | NY |
Postal Code: | 117381427 |
Phone Number: | 6318467339 |
Fax Number: | |
NPI Enumeration Date: | 01/09/2013 |
NPI Last Update Date: | 01/09/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 174400000X |
License Number: | 803394 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NY |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Specialist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |