Organization
NORTHEAST VITREO-RETINAL ASSOC, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. HOWARD TANENBAUM MD (PRESIDENT)
(518) 465-1069
Entity
Organization
Contact information
Practice address
350 NORTHERN BLVD, SUITE 301, ALBANY, NY 12204-1000
(518) 465-1069
Mailing address
350 NORTHERN BLVD, SUITE 301, ALBANY, NY 12204-1000
(518) 465-1069
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01793420
—
NY
Enumeration date
11/08/2006
Last updated
10/30/2013
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