Provider Demographics
NPI:1407391865
Name:MEKO, TEZERASH
Entity Type:Individual
Prefix:
First Name:TEZERASH
Middle Name:
Last Name:MEKO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2108 HARLEQUIN TER
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20904-5371
Mailing Address - Country:US
Mailing Address - Phone:240-547-7091
Mailing Address - Fax:
Practice Address - Street 1:2108 HARLEQUIN TER
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20904-5371
Practice Address - Country:US
Practice Address - Phone:240-547-7091
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-12-21
Last Update Date:2016-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide