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Individual

JOSEPH TEBANDEKE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
31 UNION SQ, SOMERVILLE, MA 02143-3033
(617) 372-3409
Mailing address
237 EASTERN AVE APT 2, MALDEN, MA 02148-5628
(781) 475-9130

Taxonomy

Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LN97961
MA

Other

Enumeration date
03/29/2020
Last updated
03/29/2020
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