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General NPI Number Information
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NPI Number | 1548635766
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Entity Type | Organization
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Legal Business Name | MARTIN TESHER MDPC
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Dates
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Enumeration Date | 12/14/2015
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Last Update Date | 12/14/2015
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Provider Practice Location Address
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Address Line | 9 E 68TH ST 1C
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City | NEW YORK
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State | NY
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Zip | 10065-4915
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Country | US
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Telephone | 212-639-1800
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Fax | 212-639-9506
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Provider Business Mailing Address
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Address Line | 9 E 68TH ST 1C
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City | NEW YORK
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State | NY
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Zip | 10065-4915
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Country | US
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Telephone | 212-639-1800
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Fax | 212-639-9506
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | YVONNE DEACON
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Credential |
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Telephone | 212-639-1800
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171W00000X
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Taxonomy Name | Contractor
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License Number | 170832
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License Number State | NY
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