Provider Type Icon

SUSAN H TANNENBAUM MD NPI 1447257704


NPI Information

NPI: 1447257704
Provider Name: SUSAN H TANNENBAUM, MD
Classification: Internal Medicine - 207RH0003X
Entity Type: Individual

Specialization: Hematology & Oncology

Organization: UNIVERSITY OF CONNECTICUT HEALTH CENTER

PECOS Registration: Yes

Address:
263 FARMINGTON AVE
FARMINGTON, CT
ZIP 06030
Phone: (860) 679-2100
Get Directions

Susan H Tannenbaum, MD is a hematology and oncology internal medicine in Farmington, CT with 46 years of experience. The provider is an internist doctor of osteopathy that specializes in the treatment of the combination of hematology and oncology disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine WAS able to obtain a Certificate of Special Qualifications in the field of Hematology and Oncology. The Certificate is NO longer offered. Susan H Tannenbaum, MD NPI is 1447257704. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

Education
Medical School: STATE UNIVERSITY OF NEW YORK DOWNSTATE MEDICAL CENTER
Graduation Year:1978

The provider's business location address is:

263 FARMINGTON AVE
FARMINGTON, CT
ZIP 06030-001
Phone: (860) 679-2100
Fax: (860) 679-4815

The NPI 1447257704 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 7/1/2005 and was last updated on 1/15/2010.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207RH0003XInternal MedicineHematology & Oncology041311CONNECTICUTYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1C32919MEDICARE UPINCONNECTICUT
21413111MEDICAIDCONNECTICUT
3820000021MEDICARE PINCONNECTICUT

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.