Provider Demographics
NPI:1639915622
Name:TEKAE, BINYAM
Entity type:Individual
Prefix:
First Name:BINYAM
Middle Name:
Last Name:TEKAE
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 1:6105 S WILSON ST
Mailing Address - Street 2:
Mailing Address - City:TEMPE
Mailing Address - State:AZ
Mailing Address - Zip Code:85283-3521
Mailing Address - Country:US
Mailing Address - Phone:206-888-7764
Mailing Address - Fax:
Practice Address - Street 1:6105 S WILSON ST
Practice Address - Street 2:
Practice Address - City:TEMPE
Practice Address - State:AZ
Practice Address - Zip Code:85283-3521
Practice Address - Country:US
Practice Address - Phone:206-888-7764
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-08
Last Update Date:2024-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)