Individual
DR. NICHOLAS STEPHEN TEODORO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4 SMITH HAVEN MALL STE 1, LAKE GROVE, NY 11755-1219
(631) 444-4686
(631) 444-4622
Mailing address
101 NICOLLS RD # HSC8, STONY BROOK, NY 11794-0001
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
318989
NY
Other
Enumeration date
05/08/2018
Last updated
08/12/2025
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