Provider Demographics
NPI:1437459385
Name:GABRIEL TENEMBAUM, M.D., A.P.C.
Entity Type:Organization
Organization Name:GABRIEL TENEMBAUM, M.D., A.P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:GABRIEL
Authorized Official - Middle Name:
Authorized Official - Last Name:TENEMBAUM
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:845-369-9556
Mailing Address - Street 1:233 LAFAYETTE AVE STE M4
Mailing Address - Street 2:
Mailing Address - City:SUFFERN
Mailing Address - State:NY
Mailing Address - Zip Code:10901-4822
Mailing Address - Country:US
Mailing Address - Phone:845-369-9556
Mailing Address - Fax:845-369-9717
Practice Address - Street 1:233 LAFAYETTE AVE STE M4
Practice Address - Street 2:
Practice Address - City:SUFFERN
Practice Address - State:NY
Practice Address - Zip Code:10901-4822
Practice Address - Country:US
Practice Address - Phone:845-369-9556
Practice Address - Fax:845-369-9717
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-26
Last Update Date:2011-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY60N281207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty