Tesfa Legair

Individual provider Active NPI Licensed Practical Nurse · Peekskill, NY

NPI 1194070573 · NPPES record last updated Jul 20, 2012

Key facts

NPI
1194070573
Entity type
Individual (NPI type 1)
Primary specialty
Licensed Practical Nurse 164W00000X
License
308375 (NY)
Practice address
1422 Main St
Peekskill, NY 10566-3113
Phone
(347) 791-0537
NPI assigned
Jul 20, 2012
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
308375NYMDAdult Health Nurse Practitioner

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 308375 NY Yes

Addresses

Primary practice location

1422 Main St
Peekskill, NY 10566-3113

Mailing address

1422 Main St
Peekskill, NY 10566-3113

Other providers in Peekskill, NY

All providers in Peekskill, NY · Licensed Practical Nurse in New York

Sources for this page

Verify at the official NPI Registry.