MEDICARE: MRS. TENE KAIA MCDONALD-GELIN FNP

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	363LF0000X	Family Nurse Practitioner	343896	NY

General Provider Information

NPI Number	:	1518439835
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. TENE KAIA MCDONALD-GELIN FNP

Provider Business Mailing Address
First Line	:	1894 WALTON AVE
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10453-6018
Country	:	US
Telephone Number	:	718-583-3060
Fax Number	:	718-583-3360

Provider Business Practice Location Address
First Line	:	890 TRINITY AVE APT 15D
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10456-7422
Country	:	US
Telephone Number	:	917-207-1900
Fax Number	:	718-292-4194

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

Provider Enumeration Date	:	12/27/2018
Last Update Date	:	04/16/2019

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