Active NPI
Yonathan Tegenu
- Optician
- New York, NY
National Provider Identifier
1003460601
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optician
- License
- 009269
- Practice address
- 241 W 57TH St
New York, NY 10019-2121 - Phone
- (212) 336-8329
- Fax
- (212) 245-2587
- NPI assigned
- Jul 31, 2019
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optician | 156FX1800X | 009269 | NY | Primary |
Addresses
Primary practice location
241 W 57TH St
New York, NY 10019-2121
Mailing address
11605 N Lamar Blvd
Austin, TX 78753-2658
Phone (737) 222-6996
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 009269 | NY | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1564531200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1564531200000",
"number": "1003460601",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11605 N LAMAR BLVD",
"city": "AUSTIN",
"state": "TX",
"postal_code": "787532658",
"telephone_number": "737-222-6996",
"fax_number": "512-522-8836"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "241 W 57TH ST",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100192121",
"telephone_number": "212-336-8329",
"fax_number": "212-245-2587"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TEGENU",
"first_name": "YONATHAN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2019-07-31",
"last_updated": "2019-07-31",
"status": "A"
},
"taxonomies": [
{
"code": "156FX1800X",
"taxonomy_group": "",
"desc": "Technician/Technologist, Optician",
"state": "NY",
"license": "009269",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in New York, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.