1578646246 NPI number — THOMAS JOSEPH TESI M.S., D.C.

NPI Number: 1578646246
Health Care Provider/Practitioner: THOMAS JOSEPH TESI M.S., D.C.

NPI Number : 1578646246 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1578646246",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "TESI",
    "FirstName": "THOMAS",
    "MiddleName": "JOSEPH",
    "NamePrefix": "DR.",
    "NameSuffix": null,
    "Credential": "M.S., D.C.",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "611 S MOUNTAIN RD",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "NEW CITY",
    "MailingAddressStateName": "NY",
    "MailingAddressPostalCode": "10956-5706",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "845-634-8961",
    "MailingAddressFaxNumber": "845-639-0625",
    "FirstLinePracticeLocationAddress": "4120 BROADWAY",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "NEW YORK",
    "PracticeLocationAddressStateName": "NY",
    "PracticeLocationAddressPostalCode": "10033-3703",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "212-568-7403",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "10/24/2006",
    "LastUpdateDate": "07/09/2007",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "M",
    "Gender": "Male",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "111NS0005X",
        "TaxonomyName": "Sports Physician Chiropractor",
        "LicenseNumber": "X004644",
        "LicenseNumberStateCode": "NY",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}