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NPI Code Detail

MEDICARE: IRENE ELVIRA TESTERMAN

MEDICARE: IRENE ELVIRA TESTERMAN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1104100000XSocial WorkerS.1201431OH

General Provider Information

NPI Number : 1851894703
Entity Type Code : Individual
Provider Name (Legal Business Name) : IRENE ELVIRA TESTERMAN
Provider Business Mailing Address
First Line : 1113 BACCARAT DR
Second Line :
City : COLUMBUS
State : OH
Zip : 43228-9110
Country : US
Telephone Number : 614-535-7017
Fax Number :
Provider Business Practice Location Address
First Line : 199 S CENTRAL AVE
Second Line :
City : COLUMBUS
State : OH
Zip : 43223-1301
Country : US
Telephone Number : 614-535-7017
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/16/2018
Last Update Date : 03/16/2018

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Directions to “ IRENE ELVIRA TESTERMAN ” Practice Location

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