Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RG0100X | Gastroenterologist | 54849 | NJ |
NPI | 1003873928 |
---|---|
Provider Name | Dr. Michael R. Tendler |
First Address | Marlboro, NJ 07746-1059 |
Second Address | Marlboro, NJ 07746-1059 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/04/2006 |
Last Update Date | 10/01/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
F30839 | (02) | NJ |