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General NPI Number Information
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NPI Number | 1396623195
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Entity Type | Organization
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Legal Business Name | JARED TANNENBAUM MD LLC
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Dates
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Enumeration Date | 08/21/2025
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Last Update Date | 09/26/2025
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Provider Practice Location Address
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Address Line | 50 RESERVE RD
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City | DANBURY
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State | CT
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Zip | 06810-5182
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Country | US
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Telephone | 954-648-1788
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1001
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City | SOUTHPORT
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State | CT
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Zip | 06890-2001
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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 | OWNER
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Name | JARED TANNENBAUM
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Credential | MD
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Telephone | 954-648-1788
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number |
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License Number State |
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