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General NPI Number Information
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NPI Number | 1225526817
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Entity Type | Individual
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Provider Name | MICHAEL TENORE DO
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Gender | Male
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Dates
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Enumeration Date | 04/29/2018
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Last Update Date | 11/05/2024
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Provider Practice Location Address
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Address Line | 679 MONTAUK HWY
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City | MONTAUK
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State | NY
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Zip | 11954-5340
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Country | US
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Telephone | 631-668-3705
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Fax | 631-668-1148
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Provider Business Mailing Address
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Address Line | 679 MONTAUK HWY
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City | MONTAUK
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State | NY
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Zip | 11954-5340
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 315796
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License Number State | NY
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