DR. THERESA MARIE WEGMAN MD NPI 1437117553

NPI Information

NPI: 1437117553
Provider Name: DR. THERESA MARIE WEGMAN, MD
Classification: Pediatrics - 2080A0000X
Entity Type: Individual

Specialization: Adolescent Medicine

CLIA Number: 33D0889143

Address:
24 CARROW ST
ORCHARD PARK, NY
ZIP 14127
Phone: (716) 662-3443
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DR. Theresa Marie Wegman, MD is an adolescent medicine pediatrics in Orchard Park, NY. The provider is a pediatrician who specializes in adolescent medicine is a multi-disciplinary healthcare specialist trained in the unique physical, psychological and social characteristics of adolescents, their healthcare problems and needs. DR. Theresa Marie Wegman, MD NPI is 1437117553. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

24 CARROW ST
ORCHARD PARK, NY
ZIP 14127-604
Phone: (716) 662-3443
Fax: (716) 972-0374

The CLIA number assigned to this NPI record is 33D0889143 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 5/1/2006 and was last updated on 6/26/2008.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	2080A0000X	Pediatrics	Adolescent Medicine	204233	NEW YORK	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	01924689	MEDICAID	NEW YORK
2	1210624	OTHER	NEW YORK	INDEPENDENT HEALTH ASSOCIATION
3	00020530902	OTHER	NEW YORK	UNIVERA HEALTHCARE)
4	000525566002	OTHER	NEW YORK	BLUE CROS/BLUE SHEILD (HEALTH NOW)

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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