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NPI Code Detail

MEDICARE: TESSA JANOVSKY PA

MEDICARE: TESSA JANOVSKY PA
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
1363A00000XPhysician Assistant6765AZ

General Provider Information

NPI Number : 1538680079
Entity Type Code : Individual
Provider Name (Legal Business Name) : TESSA JANOVSKY PA
Provider Business Mailing Address
First Line : 2201 W FAIRVIEW ST STE 9
Second Line :
City : CHANDLER
State : AZ
Zip : 85224-4704
Country : US
Telephone Number : 480-470-4000
Fax Number : 480-686-8875
Provider Business Practice Location Address
First Line : 2201 W FAIRVIEW ST STE 9
Second Line :
City : CHANDLER
State : AZ
Zip : 85224-4704
Country : US
Telephone Number : 480-470-4000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/06/2017
Last Update Date : 09/26/2023

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Directions to “ TESSA JANOVSKY PA” Practice Location

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