Provider Demographics
NPI:1891001608
Name:JEFFREY P TENNER, DO, PC
Entity Type:Organization
Organization Name:JEFFREY P TENNER, DO, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:P
Authorized Official - Last Name:TENNER
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:609-463-1488
Mailing Address - Street 1:410 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:CAPE MAY COURT HOUSE
Mailing Address - State:NJ
Mailing Address - Zip Code:08210-2327
Mailing Address - Country:US
Mailing Address - Phone:609-463-1488
Mailing Address - Fax:609-463-4881
Practice Address - Street 1:410 S MAIN ST
Practice Address - Street 2:
Practice Address - City:CAPE MAY COURT HOUSE
Practice Address - State:NJ
Practice Address - Zip Code:08210-2327
Practice Address - Country:US
Practice Address - Phone:609-463-1488
Practice Address - Fax:609-463-4881
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-31
Last Update Date:2010-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MB48174208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ1393901Medicaid
NJP1130691OtherOXFORD
NJ0211084000OtherAMERIHEALTH
NJ61144OtherAETNA
NJ0211084000OtherAMERIHEALTH
NJP1130691OtherOXFORD