Individual
BASHA TEITELBAUM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSED
Contact information
Practice address
5614 15TH AVE, #5F, BROOKLYN, NY 11219-4750
(718) 853-5126
(718) 514-8693
Mailing address
5614 15TH AVE, #5F, BROOKLYN, NY 11219-4750
(718) 853-5126
(718) 514-8693
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
NY
Other
Enumeration date
11/15/2012
Last updated
11/15/2012
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