Organization
CONNETQUOT PT & CHIROPRACTIC PLLC
Active
Other names
Connetquot PTDC
Organization subpart
No
Provider details
NPI number
Authorized official
JACK TESORIERO (OWNER/CHIROPRACTOR)
(631) 738-9539
Entity
Organization
Contact information
Practice address
2805 VETERANS HWY, RONKONKOMA, NY 11779-7647
(631) 738-9539
(631) 738-8500
Mailing address
2103 DEER PARK AVE, DEER PARK, NY 11729-1317
(631) 242-4500
(631) 242-0885
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
—
—
225100000X
Physical Therapist
Primary
—
—
Other
Enumeration date
05/31/2017
Last updated
05/31/2017
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