Provider Demographics
NPI:1154304715
Name:TENUTA, JOACHIM J (MD)
Entity Type:Individual
Prefix:
First Name:JOACHIM
Middle Name:J
Last Name:TENUTA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1367 WASHINGTON AVE STE 200
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:NY
Mailing Address - Zip Code:12206-1043
Mailing Address - Country:US
Mailing Address - Phone:518-292-2632
Mailing Address - Fax:518-489-5933
Practice Address - Street 1:1367 WASHINGTON AVE STE 200
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:NY
Practice Address - Zip Code:12206-1043
Practice Address - Country:US
Practice Address - Phone:518-292-2632
Practice Address - Fax:518-489-5933
Is Sole Proprietor?:No
Enumeration Date:2005-11-28
Last Update Date:2011-06-02
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GA031191207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery