Healthcare Provider Details

I. General information

NPI: 1578646246
Provider Name (Legal Business Name): THOMAS JOSEPH TESI M.S., D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/24/2006
Last Update Date: 07/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4120 BROADWAY
NEW YORK NY
10033-3703
US

IV. Provider business mailing address

611 S MOUNTAIN RD
NEW CITY NY
10956-5706
US

V. Phone/Fax

Practice location:
  • Phone: 212-568-7403
  • Fax:
Mailing address:
  • Phone: 845-634-8961
  • Fax: 845-639-0625

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NS0005X
TaxonomySports Physician Chiropractor
License NumberX004644
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: