Individual
DR. JARED TANNENBAUM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
150 RIVERSIDE DR, NEW YORK, NY 10024-2298
(646) 505-3500
Mailing address
150 EILEEN WAY UNIT 1, SYOSSET, NY 11791-5313
(516) 855-5255
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
304733
NY
208100000X
Physical Medicine & Rehabilitation Physician
Primary
304733
NY
390200000X
Student in an Organized Health Care Education/Training Program
—
FL
Other
Enumeration date
03/28/2016
Last updated
07/28/2020
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