Provider Demographics
NPI:1033119045
Name:TESSLER, HERMAN (MD)
Entity Type:Individual
Prefix:
First Name:HERMAN
Middle Name:
Last Name:TESSLER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1443 OCEAN PKWY
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11230-6401
Mailing Address - Country:US
Mailing Address - Phone:718-376-9494
Mailing Address - Fax:718-627-1836
Practice Address - Street 1:1443 OCEAN PKWY
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11230-6401
Practice Address - Country:US
Practice Address - Phone:718-376-9494
Practice Address - Fax:718-627-1836
Is Sole Proprietor?:No
Enumeration Date:2005-08-01
Last Update Date:2007-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY139228174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY172542OtherWELLCARE-INTERNAL MED
NY273751OtherWELLCARE-GASTRO
NY139228-A15OtherHEALTHFIRST
NY2028682OtherAETNA- GASTROENTOROLOGY
NY25035OtherAETNA US HEALTH CARE
NYP392487OtherOXFORD/PRIMARY
NYOM1949OtherHIP
NY0041061OtherGHI
NYP6421984OtherOXFORD/GASTRO
NY148940101OtherHEALTH PLUS-IM
NY00771471Medicaid
NY148950101OtherHEALTH PLUS -GI
NY172542OtherWELLCARE-INTERNAL MED
NY37A141Medicare ID - Type Unspecified