Provider Demographics
NPI:1356398226
Name:TEIBEL, JEFFREY (DPM)
Entity type:Individual
Prefix:
First Name:JEFFREY
Middle Name:
Last Name:TEIBEL
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 LINCOLN PKWY
Mailing Address - Street 2:
Mailing Address - City:EAST ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14445-1413
Mailing Address - Country:US
Mailing Address - Phone:585-385-9030
Mailing Address - Fax:585-385-9124
Practice Address - Street 1:85 S UNION ST
Practice Address - Street 2:
Practice Address - City:SPENCERPORT
Practice Address - State:NY
Practice Address - Zip Code:14559-1255
Practice Address - Country:US
Practice Address - Phone:585-721-3668
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-27
Last Update Date:2025-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYN0005095213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY000912926001OtherBCBS OF WESTERN NY
NY8131OtherBLUE SHIELD
NY01684064Medicaid
NY100167EQOtherPREFERRED CARE
NYP010005095OtherBLUE CHOICE
NY000912926001OtherBCBS OF WESTERN NY
NY01684064Medicaid