Provider Demographics
NPI:1154504413
Name:BARRY TENENOUSER
Entity Type:Organization
Organization Name:BARRY TENENOUSER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:BARRY
Authorized Official - Middle Name:
Authorized Official - Last Name:TENENOUSER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:412-823-0717
Mailing Address - Street 1:146 N BELLEFIELD AVE
Mailing Address - Street 2:APT 801
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15213-2618
Mailing Address - Country:US
Mailing Address - Phone:412-823-0717
Mailing Address - Fax:
Practice Address - Street 1:21 YOST BLVD
Practice Address - Street 2:FOREST HILLS PLAZA, SUITE 217
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15221-5283
Practice Address - Country:US
Practice Address - Phone:412-823-0717
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-10
Last Update Date:2012-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1679166OtherHIGHMARK BC/BS
PA0006813330009Medicaid
PA1542750OtherGATEWAY HEALTH PLAN
PA0006813330009Medicaid