Provider Demographics
NPI:1639658230
Name:TENEYCK, EMILY (DPT)
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:
Last Name:TENEYCK
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:203 STATE ST STE 1
Mailing Address - Street 2:
Mailing Address - City:OGDENSBURG
Mailing Address - State:NY
Mailing Address - Zip Code:13669-1465
Mailing Address - Country:US
Mailing Address - Phone:315-393-2024
Mailing Address - Fax:315-393-2025
Practice Address - Street 1:203 STATE ST STE 1
Practice Address - Street 2:
Practice Address - City:OGDENSBURG
Practice Address - State:NY
Practice Address - Zip Code:13669-1465
Practice Address - Country:US
Practice Address - Phone:315-393-2024
Practice Address - Fax:315-393-2025
Is Sole Proprietor?:No
Enumeration Date:2018-08-14
Last Update Date:2022-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY043292208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation