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General NPI Number Information
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NPI Number | 1316309008
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Entity Type | Individual
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Provider Name | ANTHONY JOHN TANELLA
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Gender | Male
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Dates
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Enumeration Date | 03/22/2016
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Last Update Date | 10/15/2021
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Provider Practice Location Address
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Address Line | 1 GUSTAVE L LEVY PL BOX 1010
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City | NEW YORK
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State | NY
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Zip | 10029-6504
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Country | US
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Telephone | 212-241-1518
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Fax |
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Provider Business Mailing Address
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Address Line | 333 CEDAR ST
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City | NEW HAVEN
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State | CT
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Zip | 06510-3206
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Country | US
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Telephone | 203-785-2802
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Fax | 203-785-6664
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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 | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | 302454
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | 69601
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License Number State | CT
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