Black Tenerowicz, Kathleen
Black Tenerowicz, Kathleen is an individual health care provider with primary practice located at 1353 Dorchester Ave , Dorchester MA 02122-2932. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as her primary health care specialty. Black Tenerowicz, Kathleen can be contacted via phone (617) 288-3230.Contact Information
Primary practice address
1353 Dorchester Ave
Dorchester MA 02122-2932
Phone: (617) 288-3230
Fax: (617) 825-4972
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Family | 363LF0000X | 2269719 | Massachusetts |
Profile Details
| NPI number | 1093143968 |
|---|---|
| LBN Legal business name | Black Tenerowicz, Kathleen |
| Credentials | Nurse Practitioner (NP) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Oct 31st, 2013 |
| Last updated | Apr 5th, 2017 - about 9 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1093143968 | NPPES |
| Massachusetts | MEDICAID | 110022129 |
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