Provider Demographics
NPI:1184274870
Name:BROWN, TENNEAU TIMEKA
Entity type:Individual
Prefix:MS
First Name:TENNEAU
Middle Name:TIMEKA
Last Name:BROWN
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 1:14133 PERSHING CRES APT 4B
Mailing Address - Street 2:
Mailing Address - City:JAMAICA
Mailing Address - State:NY
Mailing Address - Zip Code:11435-1985
Mailing Address - Country:US
Mailing Address - Phone:347-458-4181
Mailing Address - Fax:
Practice Address - Street 1:14133 PERSHING CRES APT 4B
Practice Address - Street 2:
Practice Address - City:JAMAICA
Practice Address - State:NY
Practice Address - Zip Code:11435-1985
Practice Address - Country:US
Practice Address - Phone:347-458-4181
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-09-16
Last Update Date:2019-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program