Provider Demographics
NPI:1053869198
Name:TURRIAGO, TERESA I
Entity type:Individual
Prefix:
First Name:TERESA
Middle Name:
Last Name:TURRIAGO
Suffix:I
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 1:487 S. BROADWAY
Mailing Address - Street 2:YONKERS
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10550
Mailing Address - Country:US
Mailing Address - Phone:914-668-8938
Mailing Address - Fax:914-668-2545
Practice Address - Street 1:487 S. BROADWAY, YONKERS
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10550
Practice Address - Country:US
Practice Address - Phone:914-668-8938
Practice Address - Fax:914-668-2545
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-19
Last Update Date:2022-07-21
Deactivation Date:2017-02-07
Deactivation Code:
Reactivation Date:2017-07-06
Provider Licenses
StateLicense IDTaxonomies
NY098254104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker