Provider Demographics
NPI:1891179461
Name:TESFAY, DANIEL G
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:G
Last Name:TESFAY
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14211 E 1ST DR UNIT 103
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80011-3860
Mailing Address - Country:US
Mailing Address - Phone:720-227-7590
Mailing Address - Fax:
Practice Address - Street 1:14211 E 1ST DR UNIT 103
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80011-3860
Practice Address - Country:US
Practice Address - Phone:720-227-7590
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-14
Last Update Date:2015-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)