Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RG0100X | Gastroenterologist | 265810 | NY |
NPI | 1043453962 |
---|---|
Provider Name | Dr. David Tenembaum |
First Address | Jackson Heights, NY 11372-7938 |
Second Address | Jackson Heights, NY 11372-7938 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/04/2009 |
Last Update Date | 17/03/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
03505039 | (05) | NY |