Healthcare Provider Details

I. General information

NPI: 1669387460
Provider Name (Legal Business Name): KAYLA ERIN TENER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KAYLA ERIN NIEUWOUDT

II. Dates (important events)

Enumeration Date: 08/17/2026
Last Update Date: 08/17/2026
Certification Date: 08/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

235 BLUE POINT AVE
BLUE POINT NY
11715-1261
US

IV. Provider business mailing address

49 ARGYLE PL
ROCKVILLE CENTRE NY
11570-2841
US

V. Phone/Fax

Practice location:
  • Phone: 475-299-2036
  • Fax:
Mailing address:
  • Phone: 475-299-2036
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: