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NPI Code Detail

MEDICARE: DR. MESERET MESHESHA TENA M.D

MEDICARE: DR. MESERET MESHESHA TENA M.D
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
1208000000XPediatrics Physician260213NY

General Provider Information

NPI Number : 1013237551
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MESERET MESHESHA TENA M.D
Provider Business Mailing Address
First Line : 230 73RD ST APT 6C
Second Line :
City : BROOKLYN
State : NY
Zip : 11209-2121
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 97 AMITY ST
Second Line :
City : BROOKLYN
State : NY
Zip : 11201-6004
Country : US
Telephone Number : 702-862-0989
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/07/2010
Last Update Date : 02/26/2013

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