# JARED TANNENBAUM MD LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1396623195
- **Authorized official:** JARED TANNENBAUM MD (OWNER)
- **Authorized official phone:** (954) 648-1788

## Contact information

- **Practice address:** 50 RESERVE RD, DANBURY, CT 06810-5182
- **Practice address phone:** (954) 648-1788
- **Mailing address:** PO BOX 1001, SOUTHPORT, CT 06890-2001

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208100000X | Physical Medicine & Rehabilitation Physician | — | NULL | Yes |
| 208100000X | Physical Medicine & Rehabilitation Physician | — | — | Yes |

## Other

- **Enumeration date:** 08/21/2025
- **Last updated:** 09/26/2025