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NPI Code Detail

MEDICARE: ARIELLE M TANNENHOLZ M.S. ED

MEDICARE: ARIELLE M TANNENHOLZ M.S. ED
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
1103T00000XPsychologistNY
2103K00000XBehavior Analyst002077NY

General Provider Information

NPI Number : 1922380252
Entity Type Code : Individual
Provider Name (Legal Business Name) : ARIELLE M TANNENHOLZ M.S. ED
Provider Business Mailing Address
First Line : 110 CHURCH ST
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19106-2201
Country : US
Telephone Number : 516-216-9992
Fax Number :
Provider Business Practice Location Address
First Line : 110 CHURCH ST
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19106-2201
Country : US
Telephone Number : 267-807-0550
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/13/2011
Last Update Date : 11/13/2023

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