MEDICARE: ANNE TENPAS PT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	0149821	NY

General Provider Information

NPI Number	:	1386927820
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANNE TENPAS PT

Provider Business Mailing Address
First Line	:	3717 VICTORIA RD
Second Line	:
City	:	ASHVILLE
State	:	NY
Zip	:	14710-9748
Country	:	US
Telephone Number	:	716-789-3407
Fax Number	:

Provider Business Practice Location Address
First Line	:	3717 VICTORIA RD
Second Line	:
City	:	ASHVILLE
State	:	NY
Zip	:	14710-9748
Country	:	US
Telephone Number	:	716-789-3407
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/21/2011
Last Update Date	:	09/21/2011

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