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General NPI Number Information
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NPI Number | 1689702375
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Entity Type | Individual
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Provider Name | STEVEN JAY TENENBAUM M.D.
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Gender | Male
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Dates
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Enumeration Date | 03/02/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 41 GERMANTOWN RD
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City | DANBURY
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State | CT
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Zip | 06810-4087
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Country | US
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Telephone | 203-207-3300
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Fax | 203-207-3310
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Provider Business Mailing Address
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Address Line | 8 WILLOW BROOK LN
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City | NEWTOWN
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State | CT
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Zip | 06470-1925
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Country | US
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Telephone | 203-270-1044
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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 | 261QC1800X
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Taxonomy Name | Corporate Health Clinic/Center
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License Number | 027120
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License Number State | CT
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