Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0120X | Pediatric Surgery | 165684 | NY |
N | 208800000X | Urologist | 165684 | NY |
NPI | 1124041827 |
---|---|
Provider Name | Steven Y Tennenbaum |
First Address | Teaneck, NJ 07666-4244 |
Second Address | Teaneck, NJ 07666-4244 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 25/07/2006 |
Last Update Date | 09/03/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
01255898 | (05) | NY |
1000042 | GHI (01) | NY |
2C1363 | HEALTHNET (01) | NY |
4225633 | AETNA/U.S.HEALTHCARE (01) | NY |
86F62 | BLUE SHIELD (01) | NY |
GS333 | OXFORD (01) | NY |