MEDICARE: TEKARA GAINEY

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
1	374J00000X	Doula

General Provider Information

NPI Number	:	1437749066
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TEKARA GAINEY

Provider Business Mailing Address
First Line	:	1821 E HAGERT ST APT 204
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19125-1249
Country	:	US
Telephone Number	:	215-200-5024
Fax Number	:

Provider Business Practice Location Address
First Line	:	1821 E HAGERT ST APT 204
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19125-1249
Country	:	US
Telephone Number	:	215-200-5024
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/18/2021
Last Update Date	:	01/18/2021

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Directions to “ TEKARA GAINEY ” Practice Location

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