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NPI Code Detail

MEDICARE: DR. SCOTT M TENNER MD

MEDICARE: DR. SCOTT M TENNER MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207RG0100XGastroenterology Physician205237NY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1750398566
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. SCOTT M TENNER MD
Provider Business Mailing Address
First Line : 2211 EMMONS AVE
Second Line :
City : BROOKLYN
State : NY
Zip : 11235
Country : US
Telephone Number : 718-368-2960
Fax Number :
Provider Business Practice Location Address
First Line : 2211 EMMONS AVE
Second Line :
City : BROOKLYN
State : NY
Zip : 11235-2792
Country : US
Telephone Number : 718-368-2960
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/02/2006
Last Update Date : 09/08/2011

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