Tara A Tedesco | Staten Island, NY • PECOS Search

Tara A Tedesco

Speech-Language Pathologist

Speech, Language and Hearing Service Providers

311 Demorest Ave, Staten Island, NY 10314-3111

PECOS Enrollment

Based on the most recent information from CMS, provider Tara A Tedesco does not have current enrollment records in PECOS.

Part B
Medicare Part B
Not Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Not Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records 2 days ago.

Profile Details

Provider ID
1396998324
Provider Type
Individual
Full Name
Tedesco, Tara A
Title
Mrs.
Credential
M.A.,CCC-SLP

Gender
Female
Sole Proprietor
Yes
Enumeration Date
11/4/2008
Last Updated
11/4/2008

Contact Information

Practice Location

311 Demorest Ave, Staten Island, NY 10314-3111

Unlisted Fax

Mailing Location

311 Demorest Ave, Staten Island, NY 10314-3111

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 235Z00000X Primary	Description Speech-Language Pathologist Speech, Language and Hearing Service Providers	License 58012294 New York