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NPI Code Detail

MEDICARE: EMMA TETTEH LPN

MEDICARE: EMMA TETTEH LPN
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
1164W00000XLicensed Practical Nurse093801-1NY

General Provider Information

NPI Number : 1235380023
Entity Type Code : Individual
Provider Name (Legal Business Name) : EMMA TETTEH LPN
Provider Business Mailing Address
First Line : 3515 EASTCHESTER RD
Second Line : 3RD FLOOR
City : BRONX
State : NY
Zip : 10469-1670
Country : US
Telephone Number : 718-944-1776
Fax Number : 718-944-1779
Provider Business Practice Location Address
First Line : 3515 EASTCHESTER RD
Second Line : 3RD FLOOR
City : BRONX
State : NY
Zip : 10469-1670
Country : US
Telephone Number : 718-944-1776
Fax Number : 718-944-1779
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/10/2008
Last Update Date : 10/10/2008

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Directions to “ EMMA TETTEH LPN” Practice Location

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