Individual
STEVEN Y TENNENBAUM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
699 TEANECK RD, ROOM 103, TEANECK, NJ 07666-4244
(201) 692-9550
(201) 692-1363
Mailing address
699 TEANECK RD, ROOM 103, TEANECK, NJ 07666-4244
(201) 692-9550
(201) 692-1363
Taxonomy
Speciality
Code
Description
License number
State
2086S0120X
Pediatric Surgery Physician
Primary
165684
NY
208800000X
Urology Physician
165684
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01255898
—
NY
01
—
1000042
GHI
NY
01
—
2C1363
HEALTHNET
NY
01
—
4225633
AETNA/U.S.HEALTHCARE
NY
01
—
86F62
BLUE SHIELD
NY
01
—
GS333
OXFORD
NY
Enumeration date
07/25/2006
Last updated
03/09/2011
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