MEDICARE: ROBERT A. TESTO D.D.S.

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	122300000X	Dentist	033832	NY

General Provider Information

NPI Number	:	1710134168
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROBERT A. TESTO D.D.S.

Provider Business Mailing Address
First Line	:	297-299 HAMILTON STREET
Second Line	:	2ND FLOOR
City	:	ALBANY
State	:	NY
Zip	:	12210-1707
Country	:	US
Telephone Number	:	518-463-2262
Fax Number	:	518-463-2263

Provider Business Practice Location Address
First Line	:	297-299 HAMILTON STREET
Second Line	:	2ND FLOOR
City	:	ALBANY
State	:	NY
Zip	:	12210-1707
Country	:	US
Telephone Number	:	518-463-2262
Fax Number	:	518-463-2263

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

Provider Enumeration Date	:	08/27/2008
Last Update Date	:	08/27/2008

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