Healthcare Provider Details

I. General information

NPI: 1164963823
Provider Name (Legal Business Name): JOSEPH TEZI
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/14/2017
Last Update Date: 03/14/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14013 WESTVIEW FOREST DR
BOWIE MD
20720-4867
US

IV. Provider business mailing address

14013 WESTVIEW FOREST DR
BOWIE MD
20720-4867
US

V. Phone/Fax

Practice location:
  • Phone: 301-996-1411
  • Fax:
Mailing address:
  • Phone: 301-996-1411
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License Number2322-1967
License Number StateWV
# 2
Primary TaxonomyY
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number2322-1967
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: