Provider Information for 1225036254
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HOWARD TENNEN PhD
Sex: Male
NPI: 1225036254
Last Updated: 2012-06-15
Certification Date:
Certification Date:
Details
| Name | Value | ||||||||
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| NPI | 1225036254 | ||||||||
| Enumeration Date | 2005-07-13 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | NO | ||||||||
| Status | Active | ||||||||
| Mailing Address | 263 FARMINGTON AVE PROVIDER ENROLLMENT FARMINGTON, CT 06030-2212 United States Phone: 860-679-7503 | Fax:860-679-1610 | ||||||||
| Primary Practice Address | 10 TALCOTT NOTCH FARMINGTON, CT 06030-0001 United States Phone: 860-679-6700 | Fax:860-679-6736 | ||||||||
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