Individual
MARC R TANNENBAUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
122 E 76TH ST, NEW YORK, NY 10021-2833
(212) 434-2878
Mailing address
PO BOX 26642, NEW YORK, NY 10087-6642
(201) 804-2800
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
183144-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01630602
—
NY
Enumeration date
12/14/2006
Last updated
04/30/2008
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