Individual
MS. CHEYENNE A TEDESCO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
641 US HIGHWAY 130, HAMILTON, NJ 08691-2101
(609) 568-9383
Mailing address
5000 COX RD, GLEN ALLEN, VA 23060-9263
(804) 968-5700
Taxonomy
Speciality
Code
Description
License number
State
207QA0505X
Adult Medicine Physician
OA004938
PA
363A00000X
Physician Assistant
Primary
25MP00699800
NJ
363A00000X
Physician Assistant
MA060823
PA
363A00000X
Physician Assistant
OA004938
PA
Other
Enumeration date
08/18/2019
Last updated
05/02/2022
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