MEDICARE: NAOMI R TESSLER

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	183500000X	Pharmacist	037820-1	NY

General Provider Information

NPI Number	:	1477876829
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NAOMI R TESSLER

Provider Business Mailing Address
First Line	:	1726 OCEAN AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11230-5401
Country	:	US
Telephone Number	:	718-252-6861
Fax Number	:

Provider Business Practice Location Address
First Line	:	5504 13TH AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11219-4515
Country	:	US
Telephone Number	:	718-436-6088
Fax Number	:

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

Provider Enumeration Date	:	03/11/2010
Last Update Date	:	03/11/2010

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Directions to “ NAOMI R TESSLER ” Practice Location

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