Individual provider Active NPI

Ayla Asa Teitelbuam, D.AC.

  • Acupuncturist
  • Providence, RI
National Provider Identifier
1104050665
Registry record updated May 12, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
AcupuncturistTaxonomy code 171100000X
License
DA00298 Issued in RI
Practice address
111 Chestnut St
Lower Level
Providence, RI 02903-4169
Phone
(401) 368-5940
NPI assigned
May 12, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 12, 2009

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acupuncturist 171100000X DA00298 RI Primary

Addresses

Primary practice location

111 Chestnut St
Lower Level
Providence, RI 02903-4169

Mailing address

111 Chestnut St
Lower Level
Providence, RI 02903-4169
Phone (401) 368-5940

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
DA00298RIMDAcupuncturist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1242086400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1242086400000",
    "number": "1104050665",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 CHESTNUT ST",
            "address_2": "LOWER LEVEL",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029034169",
            "telephone_number": "401-368-5940"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 CHESTNUT ST",
            "address_2": "LOWER LEVEL",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029034169",
            "telephone_number": "401-368-5940"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TEITELBUAM",
        "first_name": "AYLA",
        "middle_name": "ASA",
        "credential": "D.AC.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-05-12",
        "last_updated": "2009-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "RI",
            "license": "DA00298",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Providence, RI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.