Individual
JACK JAMES TESORIERO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DC
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
Primary
X004766
NY
Other
Enumeration date
09/30/2005
Last updated
07/01/2021
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