Individual
MICHAEL JOHN TEISL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
300 CRITTENDEN BLVD, ROCHESTER, NY 14642-0001
(585) 275-5228
Mailing address
601 ELMWOOD AVE, BOX: PSYCH, ROCHESTER, NY 14642-0001
(585) 275-5228
(585) 276-0161
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
018295
NY
103TC0700X
Clinical Psychologist
Primary
0182951
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03166718
—
NY
Enumeration date
09/24/2009
Last updated
03/29/2011
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