Tara A Tedesco, M.A.,CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

58012294 Issued in NY

Practice address

311 Demorest Ave
Staten Island, NY 10314-3111

Phone

(718) 448-1589

NPI assigned

Nov 4, 2008

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Tara A Vurckio Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

State licenses

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

{
    "created_epoch": "1225756800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1225756800000",
    "number": "1396998324",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "311 DEMOREST AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103143111",
            "telephone_number": "718-448-1589"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "311 DEMOREST AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103143111",
            "telephone_number": "718-448-1589"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TEDESCO",
        "first_name": "TARA",
        "middle_name": "A",
        "name_prefix": "Mrs.",
        "credential": "M.A.,CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-11-04",
        "last_updated": "2008-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NY",
            "license": "58012294",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TARA",
            "last_name": "VURCKIO",
            "middle_name": "A",
            "credential": "M.A.,CCC-SLP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Dominica Tecza, PA-C
• Samantha Tedeschi
• Danielle Tedesco
• Kathleen Tedesco, LCSW
• Salvatore A Tedesco Sr., M.D.
• Danielle D Teelucksingh, MSED
• Melissa Esther Tehrani, M.S., CF-SLP
• Armin Tehrany, MD
• Jamshid M Tehrany, MD
• Patricia Ellen Teixeira, LMT

• Speech-Language Pathologist in Staten Island, NY
• Providers in Staten Island, NY by specialty
• Speech-Language Pathologist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2008; 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.