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NPI Code Detail

MEDICARE: TEPS LLC

MEDICARE: TEPS LLC
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
13336C0003XCommunity/Retail Pharmacy028119NY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
13352957OTHEROTHER ID NUMBER-COMMERCIAL NUMBER

General Provider Information

NPI Number : 1477605525
Entity Type Code : Organization
Provider Name (Legal Business Name) : TEPS LLC
Provider Business Mailing Address
First Line : 1563 RALPH AVE
Second Line :
City : BROOKLYN
State : NY
Zip : 11236-3127
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1563 RALPH AVE
Second Line :
City : BROOKLYN
State : NY
Zip : 11236-3127
Country : US
Telephone Number : 718-676-0697
Fax Number : 718-676-0759
Authorized Official
Title or Position : SP
Name : JINNAH TANIS
Credential :
Telephone Number : 718-222-0697
Provider Enumeration Date : 01/17/2007
Last Update Date : 04/14/2010

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Directions to “TEPS LLC ” Practice Location

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