Provider Demographics
NPI:1861935090
Name:TEKEH, VERONICA TENGUH
Entity type:Individual
Prefix:
First Name:VERONICA
Middle Name:TENGUH
Last Name:TEKEH
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 1:2934 VISTA ST NE
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20018-2636
Mailing Address - Country:US
Mailing Address - Phone:786-709-1490
Mailing Address - Fax:
Practice Address - Street 1:2934 VISTA ST NE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20018-2636
Practice Address - Country:US
Practice Address - Phone:786-709-1490
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-11-20
Last Update Date:2016-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCHHA12101251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health