Healthcare Provider Details

I. General information

NPI: 1295713782
Provider Name (Legal Business Name): DAVID HARRISON TEGAY D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/04/2006
Last Update Date: 10/24/2025
Certification Date: 10/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3 AUTUMN DR
MOUNT SINAI NY
11766-2301
US

IV. Provider business mailing address

3 AUTUMN DR
MOUNT SINAI NY
11766-2301
US

V. Phone/Fax

Practice location:
  • Phone: 631-793-7228
  • Fax:
Mailing address:
  • Phone: 631-793-7228
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207SG0201X
TaxonomyClinical Genetics (M.D.) Physician
License Number222699
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number222699
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: