Provider Demographics
NPI:1851539399
Name:DUNN, TERESA (PHD)
Entity type:Individual
Prefix:DR
First Name:TERESA
Middle Name:
Last Name:DUNN
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1212 ROUTE 25A
Mailing Address - Street 2:
Mailing Address - City:STONY BROOK
Mailing Address - State:NY
Mailing Address - Zip Code:11790-1919
Mailing Address - Country:US
Mailing Address - Phone:631-751-0212
Mailing Address - Fax:631-751-0944
Practice Address - Street 1:1212 ROUTE 25A
Practice Address - Street 2:
Practice Address - City:STONY BROOK
Practice Address - State:NY
Practice Address - Zip Code:11790-1919
Practice Address - Country:US
Practice Address - Phone:631-751-0212
Practice Address - Fax:631-751-0944
Is Sole Proprietor?:No
Enumeration Date:2009-01-21
Last Update Date:2009-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYDUNNT1170100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170100000XOther Service ProvidersMedical Genetics, Ph.D. Medical Genetics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYDUNNT1OtherNYS