Organization Name: | JOSE S TISSERA MD LTD |
NPI Number: | 1881888667 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | GLENDA DARLENE MCMASTER (OFFICE MANAGER) |
Mailing Address: | 8301 Arlington Blvd #305 Fairfax |
State: | VA US |
Postal Code: | 220312902 |
Phone Number: | 7035732301 |
Fax Number: | 7035735104 |
NPI Enumeration Date: | 09/05/2007 |
NPI Last Update Date: | 09/05/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 207V00000X |
License Number: | 0101023093 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | VA |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | Obstetrics & Gynecology |
Taxonomy Specialization: | |
Taxonomy Definition: | An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women. |