Provider Demographics
NPI:1164472916
Name:TELFEIAN, ALBERT EDWARD (MD)
Entity type:Individual
Prefix:
First Name:ALBERT
Middle Name:EDWARD
Last Name:TELFEIAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:593 EDDY ST
Mailing Address - Street 2:APC 6
Mailing Address - City:PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02903-4923
Mailing Address - Country:US
Mailing Address - Phone:401-793-9153
Mailing Address - Fax:401-444-2024
Practice Address - Street 1:593 EDDY ST
Practice Address - Street 2:APC 6
Practice Address - City:PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02903-4923
Practice Address - Country:US
Practice Address - Phone:401-793-9153
Practice Address - Fax:401-444-2024
Is Sole Proprietor?:No
Enumeration Date:2006-05-11
Last Update Date:2013-08-15
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXL7897207T00000X
NJ25MA08656300207T00000X
RICMD13914207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX167188501Medicaid
TX8B4322OtherBCBS
TXH78563Medicare UPIN
TX8B4322OtherBCBS
TX167188501Medicaid