Most Relevant Information
Provider Data
| NPI Number: | 1003324906 |
| Provider Name: | JACQUELYN J TENENZAPH |
| Entity Type: | Individual |
| Taxonomy Code: | 103K00000X |
| Specialty: | Behavior Analyst |
| License Number: | 001417-1 |
Most Important Dates
| Enumeration Date: | 01/14/2018 |
| Last Updated: | 01/14/2018 |
Provider Practice Location
225 BROADHOLLOW RD STE 402
MELVILLE
NY
117474899
Practice Location Phone/Fax
| Phone: | 6313857780 |
| Fax: | 6313857795 |
Provider Mailing Location
7000 AUSTIN ST
FOREST HILLS
NY
113751022
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |