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Organization
DP PT & CHIROPRACTIC, PLLC
Active
Organization
DP PT & CHIROPRACTIC, PLLC
Active
Other names
Deer Park PTDC
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JACK J TESORIERO DC (MANAGING MEMBER)
(631) 242-4500
Entity
Organization
Contact information
Practice address
2103 DEER PARK AVE, DEER PARK, NY 11729-1319
(631) 242-4500
(631) 242-0885
Mailing address
2103 DEER PARK AVE, DEER PARK, NY 11729-1319
(631) 242-4500
(631) 242-0885
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
004766
NY
225100000X
Physical Therapist
Primary
004142
NY
Other
Enumeration date
04/06/2015
Last updated
07/01/2021
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