Provider Demographics
NPI:1568137388
Name:EDEA, TEMESGEN GETACHEW (MD)
Entity Type:Individual
Prefix:DR
First Name:TEMESGEN
Middle Name:GETACHEW
Last Name:EDEA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2514 LURTING AVE
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10469-4409
Mailing Address - Country:US
Mailing Address - Phone:832-692-8227
Mailing Address - Fax:
Practice Address - Street 1:2514 LURTING AVE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10469-4409
Practice Address - Country:US
Practice Address - Phone:832-692-8227
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-13
Last Update Date:2021-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program