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Individual

ROCHELLE RENEE TEAGUE-SMITH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
1155 HAWTHORNE RD, BENSALEM, PA 19020-3904
(267) 205-2494
Mailing address
1155 HAWTHORNE RD, BENSALEM, PA 19020-3904
(267) 205-2494

Taxonomy

Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
23011510
NY
363AM0700X
Medical Physician Assistant
Primary
MA002141L
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
23011510
NEW YORK LICENSE
NY
Enumeration date
11/29/2006
Last updated
07/14/2010
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