Active NPI
Alexis Tedesco
- Specialist
- Medford, NY
National Provider Identifier
1528788080
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- 2697512
- Practice address
- 1 Industrial Blvd
Medford, NY 11763-2220 - Phone
- (631) 297-3202
- NPI assigned
- Sep 2, 2022
- Last updated
- Sep 2, 2022
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | 2697512 | NY | Primary |
Addresses
Primary practice location
1 Industrial Blvd
Medford, NY 11763-2220
Mailing address
1 Industrial Blvd
Medford, NY 11763-2220
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2697512 | NY | MD | Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1662076800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1662076800000",
"number": "1528788080",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1 INDUSTRIAL BLVD",
"city": "MEDFORD",
"state": "NY",
"postal_code": "117632220"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1 INDUSTRIAL BLVD",
"city": "MEDFORD",
"state": "NY",
"postal_code": "117632220",
"telephone_number": "631-297-3202"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TEDESCO",
"first_name": "ALEXIS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-09-02",
"last_updated": "2022-09-02",
"certification_date": "2022-09-02",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "NY",
"license": "2697512",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Medford, NY
- Edmund Tam, RPH
- Hajar Taman
- Michael John Tamer Jr., PHARM D.
- Danielle Tanzi, LCSW
- Julie I Tavares
- Tender Loving Care Health Care Services of Long Island, LLC (Staff Builders Services)
- Tender Loving Care Health Care Services of Nassau Suffolk, LLC (Tender Loving Care, an Amedisys Company)
- Shannon Thayer, MS, CCC-SLP
- The Lake Grove School
- The Mia Center LLC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.