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STEPHEN TEITELBAUM

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
3131 KINGS HWY, BROOKLYN, NY 11234-2644
(718) 377-3775
(718) 377-3776
Mailing address
2200 N MAYFAIR RD, SUITE 200, WAUWATOSA, WI 53226-2252
(414) 258-9511
(414) 607-3948

Taxonomy

Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
159607
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
01801532
NY
01
340019331
RAILROAD MEDICARE
Enumeration date
11/29/2005
Last updated
10/09/2012
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