Individual
ASHLEY PAIGE TETA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S., PA-C
Contact information
Practice address
505 GRAND BLVD STE 1, DEER PARK, NY 11729-5300
(631) 243-1313
Mailing address
17 DUANE ST, FARMINGDALE, NY 11735-4201
(732) 407-0252
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
023271
NY
363A00000X
Physician Assistant
Primary
023271
—
Other
Enumeration date
02/15/2019
Last updated
08/23/2023
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