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Contact Information

ASHLEY P TETA, M.S., PA-C
505 GRAND BLVD STE 1
DEER PARK, NY11729-5300
 Phone: 631-243-1313
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Physician Assistant

363A00000X 97 Physician Assistant
 

Dermatology

207N00000X 07 Physician/Dermatology
Indicates primary specialty

NPI Profile & details for ASHLEY P TETA · (Female)

NPI Number 1518423490
Status Active
Credentials M.S., PA-C
Entity Individual
Enumeration date 02/15/2019
Last updated 08/23/2023 - About 3 years ago
Sole proprietor 1 No
Identifiers
  • License # 023271
  • NY License # 023271
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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