Provider Demographics
NPI:1518920396
Name:TENSER, SUZANNE M (MD)
Entity Type:Individual
Prefix:DR
First Name:SUZANNE
Middle Name:M
Last Name:TENSER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:81 S MAIN ST
Mailing Address - Street 2:SUITE 5
Mailing Address - City:WEST HARTFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06107-2405
Mailing Address - Country:US
Mailing Address - Phone:860-521-4044
Mailing Address - Fax:860-521-3885
Practice Address - Street 1:81 S MAIN ST
Practice Address - Street 2:SUITE 5
Practice Address - City:WEST HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06107-2405
Practice Address - Country:US
Practice Address - Phone:860-521-4044
Practice Address - Fax:860-521-3885
Is Sole Proprietor?:No
Enumeration Date:2006-04-11
Last Update Date:2013-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT050335208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics