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Organization
WYANDANCH PT, FAMILY HEALTH NP AND CHIROPRACTIC PLLC
Active
Organization
WYANDANCH PT, FAMILY HEALTH NP AND CHIROPRACTIC PLLC
Active
Other names
Wyandanch PTDC
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JACK TESORIERO DC (OWNER)
(631) 242-4500
Entity
Organization
Contact information
Practice address
32 STATION DRIVE, WYANDANCH, NY 11798
(631) 242-4545
(631) 242-0885
Mailing address
2103 DEER PARK AVENUE, DEER PARK, NY 11729
(631) 242-4545
(631) 242-0885
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
—
—
225100000X
Physical Therapist
Primary
—
—
363LF0000X
Family Nurse Practitioner
—
—
Other
Enumeration date
12/17/2019
Last updated
12/17/2019
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