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General NPI Number Information
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NPI Number | 1346283298
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Entity Type | Individual
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Provider Name | JEFFREY C TANENBAUM DPM
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Gender | Male
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Dates
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Enumeration Date | 06/14/2006
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Last Update Date | 06/20/2025
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Provider Practice Location Address
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Address Line | 2015 GRAND CONCOURSE
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City | BRONX
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State | NY
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Zip | 10453-4303
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Country | US
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Telephone | 185-837-7367
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Fax | 718-537-6180
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Provider Business Mailing Address
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Address Line | 2626 HALPERIN AVE
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City | BRONX
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State | NY
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Zip | 10461-2631
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Country | US
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Telephone | 718-618-0401
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Fax | 347-479-1303
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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 | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number | DP731
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 213E00000X
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Taxonomy Name | Podiatrist
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License Number | 006160
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License Number State | NY
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