Provider Demographics
NPI:1275500498
Name:TENENOUSER, BARRY (MD)
Entity Type:Individual
Prefix:
First Name:BARRY
Middle Name:
Last Name:TENENOUSER
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 1:146 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:412-302-3031
Mailing Address - Fax:412-823-9170
Practice Address - Street 1:1517 FORBES AVE
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15219-5111
Practice Address - Country:US
Practice Address - Phone:412-232-3555
Practice Address - Fax:412-823-9170
Is Sole Proprietor?:No
Enumeration Date:2006-03-07
Last Update Date:2020-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD028288L207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0016507OtherHIGHMARK
PA000681333 0009Medicaid
PA0016507 TVUMedicare ID - Type UnspecifiedHGSADMINISTRATORS
PAB32701Medicare UPIN