Active NPI
Mark Oliver Tessaro, MDCM, FRCPC, FAAP
- Pediatric Emergency Medicine (Pediatrics) Physician
- Brooklyn, NY
National Provider Identifier
1770844334
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Emergency Medicine (Pediatrics) Physician
- License
- 004032
- Practice address
- 206 Front St
Apt 6B
Brooklyn, NY 11201-1214 - Phone
- (347) 790-3621
- NPI assigned
- May 30, 2012
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Pediatric Emergency Medicine (Pediatrics) Physician | 2080P0204X | 004032 | NY | Primary |
Addresses
Primary practice location
206 Front St
Apt 6B
Brooklyn, NY 11201-1214
Mailing address
206 Front St
Apt 6B
Brooklyn, NY 11201-1214
Phone (347) 790-3621
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 004032 | NY | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1338336000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1338336000000",
"number": "1770844334",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "206 FRONT ST",
"address_2": "APT 6B",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "112011214",
"telephone_number": "347-790-3621"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "206 FRONT ST",
"address_2": "APT 6B",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "112011214",
"telephone_number": "347-790-3621"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TESSARO",
"first_name": "MARK",
"middle_name": "OLIVER",
"name_prefix": "Dr.",
"credential": "MDCM, FRCPC, FAAP",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2012-05-30",
"last_updated": "2012-05-30",
"status": "A"
},
"taxonomies": [
{
"code": "2080P0204X",
"taxonomy_group": "",
"desc": "Pediatrics, Pediatric Emergency Medicine",
"state": "NY",
"license": "004032",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Brooklyn, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 30, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.