Organization
EDWIN P TEEHAN MD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. EDWIN P TEEHAN MD (OWNER)
(973) 720-8333
Entity
Organization
Contact information
Practice address
510 HAMBURG TPKE, SUITE 205, WAYNE, NJ 07470-2025
(973) 720-8333
(973) 720-0408
Mailing address
PO BOX 4015, CLIFTON, NJ 07012-0415
(973) 720-8333
(973) 720-0408
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MA56236
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6947204
—
NJ
Enumeration date
05/26/2006
Last updated
10/19/2011
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