Provider Demographics
NPI:1063411502
Name:TENET, WILLIAM J (MD)
Entity type:Individual
Prefix:
First Name:WILLIAM
Middle Name:J
Last Name:TENET
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Gender:M
Credentials:MD
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Mailing Address - Street 1:4401 FRANCIS LEWIS BLVD
Mailing Address - Street 2:SUITE L3A
Mailing Address - City:BAYSIDE
Mailing Address - State:NY
Mailing Address - Zip Code:11361-3028
Mailing Address - Country:US
Mailing Address - Phone:718-717-0238
Mailing Address - Fax:718-717-0265
Practice Address - Street 1:1155 NORTHERN BOULEVARD
Practice Address - Street 2:SUITE 330
Practice Address - City:MANHASSET
Practice Address - State:NY
Practice Address - Zip Code:11030-3043
Practice Address - Country:US
Practice Address - Phone:516-627-4330
Practice Address - Fax:516-467-2557
Is Sole Proprietor?:No
Enumeration Date:2005-07-18
Last Update Date:2022-09-08
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Provider Licenses
StateLicense IDTaxonomies
NY156318207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00953388Medicaid
NYA400087165Medicare PIN
NYG400089700Medicare PIN
B88736Medicare UPIN