MEDICARE: DR. MARIO TESTANI MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084P0804X	Child & Adolescent Psychiatry Physician	1709671	NY

General Provider Information

NPI Number	:	1477640829
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MARIO TESTANI MD

Provider Business Mailing Address
First Line	:	40 OFFICE PARK WAY
Second Line	:
City	:	PITTSFORD
State	:	NY
Zip	:	14534-1738
Country	:	US
Telephone Number	:	585-349-9930
Fax Number	:	585-248-8558

Provider Business Practice Location Address
First Line	:	40 OFFICE PARK WAY
Second Line	:
City	:	PITTSFORD
State	:	NY
Zip	:	14534-1738
Country	:	US
Telephone Number	:	585-349-9930
Fax Number	:	585-248-8558

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/06/2006
Last Update Date	:	07/08/2007

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Directions to “ DR. MARIO TESTANI MD” Practice Location

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