Provider Demographics
NPI:1932729977
Name:TEKE, RENE II
Entity Type:Individual
Prefix:
First Name:RENE
Middle Name:
Last Name:TEKE
Suffix:II
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 1:2512 QUEENS CHAPEL RD APT 2
Mailing Address - Street 2:
Mailing Address - City:HYATTSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20782-3650
Mailing Address - Country:US
Mailing Address - Phone:240-898-8237
Mailing Address - Fax:
Practice Address - Street 1:2512 QUEENS CHAPEL RD APT 2
Practice Address - Street 2:
Practice Address - City:HYATTSVILLE
Practice Address - State:MD
Practice Address - Zip Code:20782-3650
Practice Address - Country:US
Practice Address - Phone:240-898-8237
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-04-20
Last Update Date:2020-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCHHA15220374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide