Provider Demographics
NPI:1386902153
Name:ERGUL, TERESA (RN)
Entity type:Individual
Prefix:MRS
First Name:TERESA
Middle Name:
Last Name:ERGUL
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16 LOUIS AVE
Mailing Address - Street 2:
Mailing Address - City:MORICHES
Mailing Address - State:NY
Mailing Address - Zip Code:11955-1402
Mailing Address - Country:US
Mailing Address - Phone:631-874-1402
Mailing Address - Fax:631-874-1948
Practice Address - Street 1:16 LOUIS AVE
Practice Address - Street 2:
Practice Address - City:MORICHES
Practice Address - State:NY
Practice Address - Zip Code:11955-1402
Practice Address - Country:US
Practice Address - Phone:631-874-1402
Practice Address - Fax:631-874-1948
Is Sole Proprietor?:No
Enumeration Date:2012-04-30
Last Update Date:2012-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY356427-1163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool