Provider Demographics
NPI:1215956792
Name:TANENBAUM, HOWARD LEON (HOWARD TANENBAUM)
Entity type:Individual
Prefix:DR
First Name:HOWARD
Middle Name:LEON
Last Name:TANENBAUM
Suffix:
Gender:M
Credentials:HOWARD TANENBAUM
Other - Prefix:DR
Other - First Name:HOWARD
Other - Middle Name:LEON
Other - Last Name:TANENBAUM
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:HOWARD TANENBAUM
Mailing Address - Street 1:1220 NEW SCOTLAND RD
Mailing Address - Street 2:SUITE 201
Mailing Address - City:SLINGERLANDS
Mailing Address - State:NY
Mailing Address - Zip Code:12159-9396
Mailing Address - Country:US
Mailing Address - Phone:518-533-6550
Mailing Address - Fax:518-533-6556
Practice Address - Street 1:1220 NEW SCOTLAND RD
Practice Address - Street 2:SUITE 201
Practice Address - City:SLINGERLANDS
Practice Address - State:NY
Practice Address - Zip Code:12159-9396
Practice Address - Country:US
Practice Address - Phone:518-533-6550
Practice Address - Fax:518-533-6556
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-18
Last Update Date:2020-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY158307207W00000X, 207WX0107X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207WX0107XAllopathic & Osteopathic PhysiciansOphthalmologyRetina Specialist
No207W00000XAllopathic & Osteopathic PhysiciansOphthalmology