Most Relevant Information
Provider Data
| NPI Number: | 1003460601 |
| Provider Name: | YONATHAN TEGENU |
| Entity Type: | Individual |
| Taxonomy Code: | 156FX1800X |
| Specialty: | Technician/Technologist |
| License Number: | 009269 |
Most Important Dates
| Enumeration Date: | 07/31/2019 |
| Last Updated: | 07/31/2019 |
Provider Practice Location
241 W 57TH ST
NEW YORK
NY
100192121
Practice Location Phone/Fax
| Phone: | 2123368329 |
| Fax: | 2122452587 |
Provider Mailing Location
11605 N LAMAR BLVD
AUSTIN
TX
787532658
Provider Mailing Phone/Fax
| Phone: | 7372226996 |
| Fax: | 5125228836 |