Provider Demographics
NPI:1427280494
Name:JOHN TEDESCHI, M.D., L.L.C.
Entity type:Organization
Organization Name:JOHN TEDESCHI, M.D., L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:P
Authorized Official - Last Name:TEDESCHI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:609-259-8440
Mailing Address - Street 1:54 ROBBINSVILLE ALLENTOWN RD
Mailing Address - Street 2:ONE MEDICAL PLAZA
Mailing Address - City:ROBBINSVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08691-1625
Mailing Address - Country:US
Mailing Address - Phone:609-259-8440
Mailing Address - Fax:609-259-8747
Practice Address - Street 1:54 ROBBINSVILLE ALLENTOWN RD
Practice Address - Street 2:ONE MEDICAL PLAZA
Practice Address - City:ROBBINSVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08691-1625
Practice Address - Country:US
Practice Address - Phone:609-259-8440
Practice Address - Fax:609-259-8747
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-08-10
Last Update Date:2009-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty