Provider Demographics
NPI:1235134784
Name:TENNER, JEFFREY P (DO)
Entity Type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:P
Last Name:TENNER
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 593
Mailing Address - Street 2:
Mailing Address - City:CAPE MAY COURT HOUSE
Mailing Address - State:NJ
Mailing Address - Zip Code:08210-0593
Mailing Address - Country:US
Mailing Address - Phone:609-463-2755
Mailing Address - Fax:609-463-2757
Practice Address - Street 1:217 N MAIN ST
Practice Address - Street 2:SUITE 104
Practice Address - City:CAPE MAY COURT HOUSE
Practice Address - State:NJ
Practice Address - Zip Code:08210-2165
Practice Address - Country:US
Practice Address - Phone:609-463-1488
Practice Address - Fax:609-463-4881
Is Sole Proprietor?:No
Enumeration Date:2005-06-20
Last Update Date:2014-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MB04817400208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ1088731OtherHORIZON NJ HEALTH
NJP1130691OtherOXFORD
NJ223579863OtherHORIZON
NJ0211084000OtherAMERIHEALTH
NJ1393901Medicaid
NJF17387OtherF17387
NJ4645953OtherAETNA
NJ1393901Medicaid
NJ475412Medicare ID - Type Unspecified