Organization
NORTHEAST VITREO RETINAL ASSOC PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. HOWARD L TANENBAUM MD (OWNER)
(518) 465-1069
Entity
Organization
Contact information
Practice address
349 NORTHERN BLVD, ALBANY, NY 12204
(518) 465-1069
(518) 426-8016
Mailing address
349 NORTHERN BLVD, ALBANY, NY 12204
(518) 465-1069
(518) 426-8016
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01793420
—
NY
Enumeration date
10/06/2006
Last updated
08/22/2020
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