Provider Demographics
NPI:1538542212
Name:FEALY-DUFFY, TERESA M (FNP-BC)
Entity type:Individual
Prefix:MS
First Name:TERESA
Middle Name:M
Last Name:FEALY-DUFFY
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27 TOWER HILL AVE
Mailing Address - Street 2:
Mailing Address - City:RED BANK
Mailing Address - State:NJ
Mailing Address - Zip Code:07701-2224
Mailing Address - Country:US
Mailing Address - Phone:732-580-1932
Mailing Address - Fax:
Practice Address - Street 1:470 RTE 36
Practice Address - Street 2:
Practice Address - City:HIGHLANDS
Practice Address - State:NJ
Practice Address - Zip Code:07732-1315
Practice Address - Country:US
Practice Address - Phone:866-389-2727
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-06-30
Last Update Date:2015-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ00562200363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily