Tedesco, Eleanor Theresa
Tedesco, Eleanor Theresa is an sole proprietor health care provider with primary practice located at 3922 Glenmere Dr , Myrtle Beach SC 29588-6769. She recently has only one registered license in Allopathic & Osteopathic Physicians / Psychiatry, which is considered as her primary health care specialty. Tedesco, Eleanor Theresa can be contacted via phone (508) 769-2364.Contact Information
Primary practice address
3922 Glenmere Dr
Myrtle Beach SC 29588-6769
Phone: (508) 769-2364
Fax: (843) 668-2468
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Psychiatry | 2084P0800X | 152283 | Massachusetts |
| Allopathic & Osteopathic Physicians / Psychiatry | 2084P0800X | 87398 | South Carolina |
Profile Details
| NPI number | 1700930914 |
|---|---|
| LBN Legal business name | Tedesco, Eleanor Theresa |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jan 23rd, 2007 |
| Last updated | Mar 1st, 2024 - about 8 months ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1700930914 | NPPES |
| Massachusetts | MEDICAID | 3178111 |
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