Provider Demographics
NPI:1740527647
Name:GESSLER, TESS M (MPAS)
Entity type:Individual
Prefix:MS
First Name:TESS
Middle Name:M
Last Name:GESSLER
Suffix:
Gender:F
Credentials:MPAS
Other - Prefix:MRS
Other - First Name:TESS
Other - Middle Name:M
Other - Last Name:GODIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MPAS
Mailing Address - Street 1:PO BOX 415348
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02241-5348
Mailing Address - Country:US
Mailing Address - Phone:800-225-8885
Mailing Address - Fax:508-334-1977
Practice Address - Street 1:33 KENDALL ST
Practice Address - Street 2:
Practice Address - City:WORCESTER
Practice Address - State:MA
Practice Address - Zip Code:01605-2726
Practice Address - Country:US
Practice Address - Phone:508-334-8765
Practice Address - Fax:774-443-7360
Is Sole Proprietor?:No
Enumeration Date:2013-01-11
Last Update Date:2016-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA4989363A00000X
363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAS400151636Medicare PIN