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General NPI Number Information
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NPI Number | 1013237551
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Entity Type | Individual
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Provider Name | MESERET MESHESHA TENA M.D
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Gender | Female
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Dates
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Enumeration Date | 06/07/2010
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Last Update Date | 02/26/2013
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Provider Practice Location Address
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Address Line | 97 AMITY ST
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City | BROOKLYN
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State | NY
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Zip | 11201-6004
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Country | US
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Telephone | 702-862-0989
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Fax |
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Provider Business Mailing Address
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Address Line | 230 73RD ST APT 6C
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City | BROOKLYN
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State | NY
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Zip | 11209-2121
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 260213
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License Number State | NY
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