Provider Demographics
NPI:1205083805
Name:TESSONO, MYRIAME (RN)
Entity type:Individual
Prefix:MS
First Name:MYRIAME
Middle Name:
Last Name:TESSONO
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11711 MYRTLE AVE
Mailing Address - Street 2:
Mailing Address - City:RICHMOND HILL
Mailing Address - State:NY
Mailing Address - Zip Code:11418-1751
Mailing Address - Country:US
Mailing Address - Phone:718-847-9233
Mailing Address - Fax:718-849-1093
Practice Address - Street 1:400 CROOKED HILL RD
Practice Address - Street 2:
Practice Address - City:BRENTWOOD
Practice Address - State:NY
Practice Address - Zip Code:11717-1039
Practice Address - Country:US
Practice Address - Phone:718-847-9233
Practice Address - Fax:718-849-1093
Is Sole Proprietor?:No
Enumeration Date:2008-08-26
Last Update Date:2023-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY580-822163W00000X
NY580822-1163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health
No163W00000XNursing Service ProvidersRegistered Nurse