Provider Demographics
NPI:1003537960
Name:TENENBAUM, HARLAN
Entity Type:Individual
Prefix:
First Name:HARLAN
Middle Name:
Last Name:TENENBAUM
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:55 SPRUCE ST
Mailing Address - Street 2:
Mailing Address - City:PRINCETON
Mailing Address - State:NJ
Mailing Address - Zip Code:08542-3848
Mailing Address - Country:US
Mailing Address - Phone:609-933-1630
Mailing Address - Fax:
Practice Address - Street 1:55 SPRUCE ST
Practice Address - Street 2:
Practice Address - City:PRINCETON
Practice Address - State:NJ
Practice Address - Zip Code:08542-3848
Practice Address - Country:US
Practice Address - Phone:609-933-1630
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-08
Last Update Date:2022-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes102L00000XBehavioral Health & Social Service ProvidersPsychoanalyst