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NPI Code Detail

MEDICARE: LINETTE YADIRA ROSARIO TEJEDA MD

MEDICARE: LINETTE YADIRA ROSARIO TEJEDA MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine Physician053538CT

General Provider Information

NPI Number : 1891082079
Entity Type Code : Individual
Provider Name (Legal Business Name) : LINETTE YADIRA ROSARIO TEJEDA MD
Provider Business Mailing Address
First Line : 1276 FULTON AVE FL 4
Second Line :
City : BRONX
State : NY
Zip : 10456-3402
Country : US
Telephone Number : 718-901-8294
Fax Number :
Provider Business Practice Location Address
First Line : 2979 MAIN ST
Second Line :
City : BRIDGEPORT
State : CT
Zip : 06606-4284
Country : US
Telephone Number : 203-382-2345
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/07/2011
Last Update Date : 08/25/2015

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