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Individual

DR. THERESE DEIERLEIN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
AUD

Contact information

Practice address
34 E 67TH ST, SUITE #4F, NEW YORK, NY 10065-6119
(212) 628-2710
(212) 628-3580
Mailing address
250 FORT LEE RD, STE #C, AUDIOLOGY 2000 INC, TEANECK, NJ 07666-3904
(212) 628-2710
(212) 628-3580

Taxonomy

Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
0010601
NY
231H00000X
Audiologist
41YA00028200
NJ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1000044420
AFFINITY HEALTH PLANS
01
2394820
UNITED HEALTHCARE
01
3C5894
HEALTHNET
01
4899742
GHI
01
6988043
CIGNA
01
M73741
EMPIRE BC/BS
01
P3163299
OXFORD
Enumeration date
11/02/2005
Last updated
08/19/2013
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