Provider Demographics
NPI:1972682268
Name:TENER, TRILBY JO (MD)
Entity Type:Individual
Prefix:DR
First Name:TRILBY
Middle Name:JO
Last Name:TENER
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 1:201 LYONS AVE
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07112-2027
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:201 LYONS AVE
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:NJ
Practice Address - Zip Code:07112-2027
Practice Address - Country:US
Practice Address - Phone:973-926-7342
Practice Address - Fax:973-705-8650
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-06
Last Update Date:2020-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101235999207V00000X
SC26524207V00000X
WI45837-020207V00000X
NJ25MA6773500207V00000X
ME016754207V00000X
WAMD00044257207V00000X
MI4301081835207V00000X
AK5152207V00000X
TXM2150207V00000X
NY234591-1207V00000X
IDM8960207V00000X
CAA85920207V00000X
PAMD072153-L207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AKH97316Medicare UPIN