Provider Demographics
NPI:1255699294
Name:TEKE, ODATE E
Entity type:Individual
Prefix:
First Name:ODATE
Middle Name:E
Last Name:TEKE
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 1:1816 METZEROTT RD
Mailing Address - Street 2:APT 35
Mailing Address - City:ADELPHI
Mailing Address - State:MD
Mailing Address - Zip Code:20783-5158
Mailing Address - Country:US
Mailing Address - Phone:240-305-0075
Mailing Address - Fax:
Practice Address - Street 1:1816 METZEROTT RD
Practice Address - Street 2:APT 35
Practice Address - City:ADELPHI
Practice Address - State:MD
Practice Address - Zip Code:20783-5158
Practice Address - Country:US
Practice Address - Phone:240-305-0075
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-04-27
Last Update Date:2012-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide