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General NPI Number Information
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NPI Number | 1417064528
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Entity Type | Individual
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Provider Name | DANIEL A TESKA PA-C
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Gender | Male
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Dates
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Enumeration Date | 08/24/2006
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Last Update Date | 03/12/2025
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Provider Practice Location Address
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Address Line | 3805B SPRING STREET SUITE 230
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City | RACINE
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State | WI
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Zip | 53405-1640
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Country | US
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Telephone | 262-687-4479
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Fax | 262-687-5375
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Provider Business Mailing Address
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Address Line | 1249 N SUNNYSLOPE DRIVE UNIT 205
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City | RACINE
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State | WI
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Zip | 53406-3486
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Country | US
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Telephone | 262-497-9610
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 8058
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License Number State | AZ
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 1789-023
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License Number State | WI
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