Provider Demographics
NPI:1871568592
Name:TENDLER, YACOV (MD)
Entity type:Individual
Prefix:
First Name:YACOV
Middle Name:
Last Name:TENDLER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 COLLEGE RD
Mailing Address - Street 2:
Mailing Address - City:MONSEY
Mailing Address - State:NY
Mailing Address - Zip Code:10952
Mailing Address - Country:US
Mailing Address - Phone:845-357-4958
Mailing Address - Fax:845-357-7925
Practice Address - Street 1:3 COLLEGE RD
Practice Address - Street 2:
Practice Address - City:MONSEY
Practice Address - State:NY
Practice Address - Zip Code:10952
Practice Address - Country:US
Practice Address - Phone:845-357-4958
Practice Address - Fax:845-357-7925
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-17
Last Update Date:2010-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY135395207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
RP168OtherOXFORD
NY01014391Medicaid
NY01014391Medicaid
01E711Medicare ID - Type Unspecified