Individual
DR. ROBERT WALLACE TENNEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
5645 MAIN ST, FLUSHING, NY 11355-5045
(718) 670-2000
Mailing address
2319 PEROT ST, PHILADELPHIA, PA 19130-2525
(516) 330-6112
Taxonomy
Speciality
Code
Description
License number
State
2085R0204X
Vascular & Interventional Radiology Physician
Primary
330788
NY
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/09/2018
Last updated
10/25/2024
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