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Individual

EPHREM REGASSA TEKLEMARIAM

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
47 NEW SCOTLAND AVENUE DEPT. OF MEDICINE, ALBANY, NY 12208
(571) 275-3256
Mailing address
47 NEW SCOTLAND AVENUE DEPT. OF MEDICINE, ALBANY, NY 12208
(571) 275-3256

Taxonomy

Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
MD470281
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
63810
DEPARTMENT ID NUMBER
NY
Enumeration date
04/08/2016
Last updated
03/23/2021
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