Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Dr. Jack Anthony Tesoriero, MD

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1699424275

Dr. Jack Anthony Tesoriero, MD is a Student in an Organized Health Care Education/Training Program in Stony Brook, New York. Licensed in New York. Registered with an NPI since 2022.

Licensed in
NY
In the registry since
2022
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

101 Nicolls Rd
Stony Brook, NY 11794-0001
Phone: (631) 689-8333
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Student in an Organized Health Care Education/Training Program (primary) Taxonomy 390200000X (NY)

Record details

NPI number1699424275
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedMarch 22, 2022
Last updated in NPPESMarch 22, 2022
Certification dateMarch 22, 2022

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