| Ms Lauren Taylor Tedesco, PA | |
|
611 Northern Blvd., Great Neck, NY 11021 | |
| (516) 723-2663 | |
| (516) 325-7192 |
| Full Name | Ms Lauren Taylor Tedesco |
|---|---|
| Gender | Female |
| Speciality | Physician Assistant |
| Location | 611 Northern Blvd., Great Neck, New York |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1972769578 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363A00000X | Physician Assistant | 012605 (New York) | Primary |
| 363AS0400X | Physician Assistant - Surgical | 012605-1 (New York) | Secondary |
| Entity Name | North Shore-lij Medical PC |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1053688572 PECOS PAC ID: 3375701568 Enrollment ID: O20120220000262 |
| Entity Name | Medical Services of Kips Bay PC |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1669075651 PECOS PAC ID: 0143635524 Enrollment ID: O20210217000628 |
| Mailing Address | Practice Location Address |
|---|---|
| Ms Lauren Taylor Tedesco, PA 611 Northern Blvd., Great Neck, NY 11021 Ph: (516) 723-2663 | Ms Lauren Taylor Tedesco, PA 611 Northern Blvd., Great Neck, NY 11021 Ph: (516) 723-2663 |
Michelle Stewart, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 600 Northern Blvd, Suite 300, Great Neck, NY 11021 Phone: 516-627-8717 |
John Palermo, PHYSICAN ASSISTANT Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 55 Northern Blvd, Ste 103, Great Neck, NY 11021 Phone: 516-466-9300 Fax: 516-466-9353 |
Deborah Ishaal, PA Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: 1010 Northern Blvd, Suite 208, Great Neck, NY 11021 Phone: 718-888-1467 Fax: 516-869-8653 |
Michaela Espadas, PA-C Physician Assistant Medicare: Medicare Enrolled Practice Location: 2 E Mill Dr Apt 3g, Great Neck, NY 11021 Phone: 516-581-3266 |
Rachel Julienne Dellaragione, PA Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 600 Northern Blvd Ste 310, Great Neck, NY 11021 Phone: 516-321-8900 |
Ghazaleh Yasmeh, Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: 60 Knights Bridge Rd, Apt# 1d, Great Neck, NY 11021 Phone: 818-445-1724 |
Mr. Jacob Henry Ettinger, PA Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 21 Canterbury Rd, Apartment #3, Great Neck, NY 11021 Phone: 516-570-6015 |