Provider Demographics
NPI:1295713782
Name:TEGAY, DAVID HARRISON (DO)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:HARRISON
Last Name:TEGAY
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:NYIT- NORTHERN BOULEVARD
Mailing Address - Street 2:NYCOM- PO BOX 8000
Mailing Address - City:OLD WESTBURY
Mailing Address - State:NY
Mailing Address - Zip Code:11568-8000
Mailing Address - Country:US
Mailing Address - Phone:516-686-3897
Mailing Address - Fax:516-686-3834
Practice Address - Street 1:NYIT- NORTHERN BOULEVARD
Practice Address - Street 2:NEW YORK COLLEGE OF OSTEOPATHIC MEDICINE- 8000
Practice Address - City:OLD WESTBURY
Practice Address - State:NY
Practice Address - Zip Code:11568-8000
Practice Address - Country:US
Practice Address - Phone:516-686-3897
Practice Address - Fax:516-686-3834
Is Sole Proprietor?:No
Enumeration Date:2006-01-04
Last Update Date:2011-12-05
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY222699207R00000X, 207SG0201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207SG0201XAllopathic & Osteopathic PhysiciansMedical GeneticsClinical Genetics (M.D.)
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02359731Medicaid
H64845Medicare UPIN
NY065AL1Medicare ID - Type Unspecified