Teale Lynn Didomenico

Primary specialty

Peer SpecialistTaxonomy code 175T00000X

License

409218754 Issued in NY

Practice address

3176 Abbott Rd
Orchard Park, NY 14127-1069

Phone

(716) 822-2117

NPI assigned

Jul 19, 2024

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1721347200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721779200000",
    "number": "1912745290",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3176 ABBOTT RD",
            "city": "ORCHARD PARK",
            "state": "NY",
            "postal_code": "141271069",
            "telephone_number": "716-822-2117"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3176 ABBOTT RD",
            "city": "ORCHARD PARK",
            "state": "NY",
            "postal_code": "141271069",
            "telephone_number": "716-822-2117"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIDOMENICO",
        "first_name": "TEALE",
        "middle_name": "LYNN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-07-19",
        "last_updated": "2024-07-24",
        "certification_date": "2024-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "175T00000X",
            "taxonomy_group": "",
            "desc": "Peer Specialist",
            "state": "NY",
            "license": "409218754",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Allan Depew
• Linda Deuell, OT
• Devincentis,DPM-Devincentis,DPM
• Alyssa Marie Dewes
• Albert Jose Diaz-Ordaz, MD
• Nathan Diegelman, PH.D.
• Carolyn Diercksen
• Elizabeth Dierenfield
• Kyle Dierolf, PHARMD
• Nancy Ellen Dietrick, RPH

• Peer Specialist in Orchard Park, NY
• Providers in Orchard Park, NY by specialty
• Peer Specialist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2024; 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.