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General NPI Number Information
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NPI Number | 1902209653
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Entity Type | Organization
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Legal Business Name | TEG INC.
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Dates
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Enumeration Date | 10/08/2014
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Last Update Date | 10/08/2014
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Provider Practice Location Address
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Address Line | 5975 ROSWELL RD
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City | SANDY SPRINGS
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State | GA
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Zip | 30328-4048
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Country | US
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Telephone | 404-252-4111
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Fax | 404-252-3570
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Provider Business Mailing Address
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Address Line | 520 8TH AVE 23RD FLOOR
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City | NEW YORK
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State | NY
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Zip | 10018-6507
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Country | US
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Telephone | 212-792-8149
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Fax | 646-448-3327
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Authorized Official
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Title or Position | CREDENTIALING MANAGER
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Name | LAURA VALENTIN
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Credential |
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Telephone | 212-792-8149
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number |
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License Number State |
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