Michele Tedesco

Primary specialty

Physical Rehabilitation Occupational TherapistTaxonomy code 225XP0019X

License

OC003055L Issued in PA

Practice address

901 Memorial Ave
Williamsport, PA 17701-4725

Phone

(570) 322-5433

NPI assigned

Aug 20, 2010

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Lycoming Life LLC

  • PACE Provider Organization
  • Williamsport, PA
  • NPI 1780519389
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1282262400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1282262400000",
    "number": "1336455948",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1626 MEADE ST",
            "city": "WILLIAMSPORT",
            "state": "PA",
            "postal_code": "177013715"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 MEMORIAL AVE",
            "city": "WILLIAMSPORT",
            "state": "PA",
            "postal_code": "177014725",
            "telephone_number": "570-322-5433"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TEDESCO",
        "first_name": "MICHELE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-08-20",
        "last_updated": "2010-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XP0019X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Physical Rehabilitation",
            "state": "PA",
            "license": "OC003055L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Theresa Anne Tarquinio, PA-C
• Emily Tate
• Alvine Naliaka Taylor, CRNP
• Lorrie Taylor
• Jennifer Tebbs, B.S.W
• Christa Leigh Tempesco, RDH, PHDHP
• Carmen Marie Terry, MS, ATC
• Hannah Marie Terz
• Apongnwu N.F. Tete, DO
• The Giant Company, LLC (Giant Pharmacy #6122)

• Physical Rehabilitation Occupational Therapist in Williamsport, PA
• Providers in Williamsport, PA by specialty
• Physical Rehabilitation Occupational Therapist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.