Provider Demographics
NPI:1730798752
Name:TEDLA CORPORATION
Entity type:Organization
Organization Name:TEDLA CORPORATION
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:ABBY
Authorized Official - Middle Name:
Authorized Official - Last Name:TAYE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:908-930-2476
Mailing Address - Street 1:PO BOX 322
Mailing Address - Street 2:
Mailing Address - City:SOUTH PLAINFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07080-0322
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:9056 CORIANDER CIR
Practice Address - Street 2:
Practice Address - City:MANASSAS
Practice Address - State:VA
Practice Address - Zip Code:20110-5969
Practice Address - Country:US
Practice Address - Phone:703-895-8867
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:TEDLA CORPORATION
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-07-27
Last Update Date:2020-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)