Provider Demographics
NPI:1639064769
Name:TETERINA, RUZANA
Entity type:Individual
Prefix:
First Name:RUZANA
Middle Name:
Last Name:TETERINA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6306 110TH ST APT D5
Mailing Address - Street 2:
Mailing Address - City:FOREST HILLS
Mailing Address - State:NY
Mailing Address - Zip Code:11375-1454
Mailing Address - Country:US
Mailing Address - Phone:347-751-5271
Mailing Address - Fax:
Practice Address - Street 1:6306 110TH ST APT D5
Practice Address - Street 2:
Practice Address - City:FOREST HILLS
Practice Address - State:NY
Practice Address - Zip Code:11375-1454
Practice Address - Country:US
Practice Address - Phone:347-751-5271
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-10
Last Update Date:2025-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health