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General NPI Number Information
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NPI Number | 1285821942
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Entity Type | Organization
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Legal Business Name | LAWRENCE TESSER DPM PLLC
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Dates
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Enumeration Date | 09/26/2007
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Last Update Date | 10/22/2009
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Provider Practice Location Address
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Address Line | 1800 MERRICK RD
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City | MERRICK
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State | NY
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Zip | 11566-4530
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Country | US
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Telephone | 516-377-7701
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Fax |
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Provider Business Mailing Address
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Address Line | 1800 MERRICK RD
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City | MERRICK
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State | NY
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Zip | 11566-4530
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Country | US
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Telephone | 516-377-7701
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Fax |
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Authorized Official
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Title or Position | PODIATRIST
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Name | DR. LAWRENCE MARC TESSER
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Credential | DPM
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Telephone | 516-377-7701
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number | 005175
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License Number State | NY
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