Provider Demographics
NPI:1407082985
Name:TESSER, REMY BROOKE (PAC)
Entity Type:Individual
Prefix:MRS
First Name:REMY
Middle Name:BROOKE
Last Name:TESSER
Suffix:
Gender:F
Credentials:PAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:50 CHRISTOPHER COLUMBUS DR
Mailing Address - Street 2:APT 702
Mailing Address - City:JERSEY CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:07302-7005
Mailing Address - Country:US
Mailing Address - Phone:917-658-7872
Mailing Address - Fax:
Practice Address - Street 1:653 WILLOW GROVE ST
Practice Address - Street 2:SUITE 2000
Practice Address - City:HACKETTSTOWN
Practice Address - State:NJ
Practice Address - Zip Code:07840-1732
Practice Address - Country:US
Practice Address - Phone:908-684-3005
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-06-10
Last Update Date:2009-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MP00217200363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant