Provider Demographics
NPI:1144259565
Name:GO, TERESITA ALO (MD)
Entity type:Individual
Prefix:DR
First Name:TERESITA
Middle Name:ALO
Last Name:GO
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:PO BOX 26246
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10087-6246
Mailing Address - Country:US
Mailing Address - Phone:718-604-5574
Mailing Address - Fax:718-604-5527
Practice Address - Street 1:1061 LIBERTY AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11208-2912
Practice Address - Country:US
Practice Address - Phone:718-827-5003
Practice Address - Fax:718-827-5359
Is Sole Proprietor?:No
Enumeration Date:2006-06-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY155537208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYA60514Medicare UPIN