Healthcare Provider Details

I. General information

NPI: 1891873741
Provider Name (Legal Business Name): JOHN P TEDESCHI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: JOHN TEDESCHI MD

II. Dates (important events)

Enumeration Date: 11/01/2006
Last Update Date: 08/09/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

54 ROBBINSVILLE ALLENTOWN RD ONE MEDICAL PLAZA
ROBBINSVILLE NJ
08691-1625
US

IV. Provider business mailing address

54 ROBBINSVILLE ALLENTOWN RD ONE MEDICAL PLAZA
ROBBINSVILLE NJ
08691-1625
US

V. Phone/Fax

Practice location:
  • Phone: 609-259-8440
  • Fax: 609-259-8747
Mailing address:
  • Phone: 609-259-8440
  • Fax: 609-259-8747

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberDR.0028309
License Number StateCO
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberMD176662
License Number StateOR
# 3
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberMD60705506
License Number StateWA
# 4
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number64044
License Number StateMN
# 5
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number18579
License Number StateAZ
# 6
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number036146826
License Number StateIL
# 7
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number181-320
License Number StateWI
# 8
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberMD-45442
License Number StateIA
# 9
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberMD22463
License Number StateME
# 10
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number04-41220
License Number StateKS
# 11
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number11031
License Number StateSD
# 12
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number25MA046518
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: