Salvatore A Tedesco Sr., M.D.

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

138920 Issued in NY

Practice address

17 Shift PL
Staten Island, NY 10312-1136

Phone

(718) 948-4498

Fax

(718) 948-4498

NPI assigned

Jun 22, 2005

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1119398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1383696000000",
    "number": "1891791083",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17 SHIFT PL",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103121136",
            "telephone_number": "718-948-4498",
            "fax_number": "718-948-4498"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17 SHIFT PL",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103121136",
            "telephone_number": "718-948-4498",
            "fax_number": "718-948-4498"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TEDESCO",
        "first_name": "SALVATORE",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "name_suffix": "Sr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-06-22",
        "last_updated": "2013-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NY",
            "license": "138920",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00778336",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• M. Joycelynne Y. Tecson, MD
• Dominica Tecza, PA-C
• Samantha Tedeschi
• Danielle Tedesco
• Kathleen Tedesco, LCSW
• Tara A Tedesco, M.A.,CCC-SLP
• Danielle D Teelucksingh, MSED
• Melissa Esther Tehrani, M.S., CF-SLP
• Armin Tehrany, MD
• Jamshid M Tehrany, MD

• Surgery Physician in Staten Island, NY
• Providers in Staten Island, NY by specialty
• Surgery Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2013; 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.