Provider Demographics
NPI:1578646246
Name:TESI, THOMAS JOSEPH (MS, DC)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:JOSEPH
Last Name:TESI
Suffix:
Gender:M
Credentials:MS, DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:611 S MOUNTAIN RD
Mailing Address - Street 2:
Mailing Address - City:NEW CITY
Mailing Address - State:NY
Mailing Address - Zip Code:10956-5706
Mailing Address - Country:US
Mailing Address - Phone:845-634-8961
Mailing Address - Fax:845-639-0625
Practice Address - Street 1:4120 BROADWAY
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10033-3703
Practice Address - Country:US
Practice Address - Phone:212-568-7403
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-24
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX004644111NS0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NS0005XChiropractic ProvidersChiropractorSports Physician
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYX004644OtherNY STATE LICENSE NUMBER
NYX004644OtherNY STATE LICENSE NUMBER
NYX54041Medicare ID - Type UnspecifiedMEDICARE PROVIDER ID