Individual
PETER J TENICKI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
30 SHELBURNE RD, STAMFORD, CT 06902-3628
(203) 276-7298
Mailing address
30 SHELBURNE RD, STAMFORD, CT 06902-3628
(203) 276-7298
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
041551
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
010041551CT01
ANTHEM BC/BS
CT
01
—
041551
CONNECTICARE
CT
01
—
2V4593
HEALTH NET
CT
01
—
3308535
AETNA - HMO
CT
01
—
473P62
EMPIRE BC/BS
CT
01
—
7267461
AETNA - PPO
CT
01
—
9441583
CIGNA
CT
01
—
P00074279
RAILROAD MEDICARE
CT
01
—
P3044450
OXFORD HEALTH PLAN
CT
01
—
TIN
GREAT WEST
—
Enumeration date
08/11/2006
Last updated
05/22/2008
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