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Individual

DR. ROSAMOND HANNAH TEDESCO

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
O.D.

Contact information

Practice address
12170 ABERDEEN ST NE, BLAINE, MN 55449
(763) 757-7000
(763) 757-3328
Mailing address
12170 ABERDEEN ST NE, BLAINE, MN 55449-4716
(763) 757-7000
(763) 757-3328

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
3099
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
410002980
MEDICARE
MN
05
535482200
MN
Enumeration date
07/17/2007
Last updated
07/23/2019
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