Provider Demographics
NPI:1174090872
Name:PASTOR, TESSY GISELLE (MS IN EDUCATION)
Entity type:Individual
Prefix:
First Name:TESSY
Middle Name:GISELLE
Last Name:PASTOR
Suffix:
Gender:F
Credentials:MS IN EDUCATION
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4705 CENTER BLVD APT 704
Mailing Address - Street 2:
Mailing Address - City:LONG ISLAND CITY
Mailing Address - State:NY
Mailing Address - Zip Code:11109-5639
Mailing Address - Country:US
Mailing Address - Phone:908-290-2245
Mailing Address - Fax:
Practice Address - Street 1:14628 JASMINE AVE
Practice Address - Street 2:
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11355-2248
Practice Address - Country:US
Practice Address - Phone:718-352-0104
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-31
Last Update Date:2018-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling