Provider Demographics
NPI:1447347075
Name:TEITEL, ERIC SCOTT (MD)
Entity type:Individual
Prefix:DR
First Name:ERIC
Middle Name:SCOTT
Last Name:TEITEL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1985 CROMPOND RD UPPR E
Mailing Address - Street 2:
Mailing Address - City:CORTLANDT MANOR
Mailing Address - State:NY
Mailing Address - Zip Code:10567-4146
Mailing Address - Country:US
Mailing Address - Phone:914-734-8224
Mailing Address - Fax:
Practice Address - Street 1:1985 CROMPOND RD UPPR E
Practice Address - Street 2:
Practice Address - City:CORTLANDT MANOR
Practice Address - State:NY
Practice Address - Zip Code:10567-4146
Practice Address - Country:US
Practice Address - Phone:914-734-8224
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-06
Last Update Date:2021-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT025787207RG0100X
AZ42477207RG0100X
NY142956-1207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
0035079OtherGHI
NY87401000OtherAMERIHEALTH
NYSS055OtherOXFORD HEALTH PLANS
4272535OtherAETNA
1303124OtherFIRSTHEALTH
NY36360OtherPHCS
NY4710082OtherHEALTHNOW NY
NY0D1234OtherHEALTHNET/PHS
NY100012201OtherRR MC-PALMETTO GBA
0366730003OtherCIGNA
NY37A13OtherEMPIRE BC BS
NY356195OtherMVP HEALTH PLANS
NY00833610Medicaid
NY11612OtherGHI HMO
NYSS055OtherOXFORD HEALTH PLANS