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Individual
TERA MICHELLE CIESLA
Active
Individual
TERA MICHELLE CIESLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RPA-C
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
008754
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000570437002
BC/BS
—
05
—
02504589
—
NY
01
—
9511829
IHA
—
01
—
FIDELIS
050711000014
—
01
—
UNIVERA
00026559809
—
Enumeration date
10/04/2006
Last updated
10/29/2008
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