Provider Demographics
NPI:1699105866
Name:DUDA, TERESA (RN)
Entity type:Individual
Prefix:MRS
First Name:TERESA
Middle Name:
Last Name:DUDA
Suffix:
Gender:F
Credentials:RN
Other - Prefix:MRS
Other - First Name:TERESA
Other - Middle Name:
Other - Last Name:CZAPLAK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:23 ARROWHEAD AVE
Mailing Address - Street 2:
Mailing Address - City:RIVERHEAD
Mailing Address - State:NY
Mailing Address - Zip Code:11901-6617
Mailing Address - Country:US
Mailing Address - Phone:631-369-4982
Mailing Address - Fax:
Practice Address - Street 1:23 ARROWHEAD AVE
Practice Address - Street 2:
Practice Address - City:RIVERHEAD
Practice Address - State:NY
Practice Address - Zip Code:11901-6617
Practice Address - Country:US
Practice Address - Phone:631-369-4982
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-11-25
Last Update Date:2013-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY550375163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse