Healthcare Provider Details

I. General information

NPI: 1033122080
Provider Name (Legal Business Name): ALAN RALPH TESSLER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/14/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3900 WOODLAND AVE
PHILADELPHIA PA
19104-4551
US

IV. Provider business mailing address

280 S ROBERTS RD
BRYN MAWR PA
19010-1351
US

V. Phone/Fax

Practice location:
  • Phone: 215-823-5850
  • Fax: 215-823-5969
Mailing address:
  • Phone: 215-823-5800
  • Fax: 215-823-5969

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License NumberMD012233E
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: