Individual
JENNIFER KATHERINE TESORIERO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
475 SEAVIEW AVE, STATEN ISLAND, NY 10305-3436
(718) 226-9000
Mailing address
284 GRAHAM AVE, STATEN ISLAND, NY 10314-3202
(718) 913-8114
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
018769
NY
363AS0400X
Surgical Physician Assistant
Primary
018769
NY
Other
Enumeration date
07/07/2015
Last updated
07/07/2015
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