Active NPI
Vladislav Tenenbaum
- Pharmacist
- Cleveland Heights, OH
National Provider Identifier
1205111077
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 03230378
- Practice address
- 3020 Mayfield Rd
Cleveland Heights, OH 44118 - Phone
- (216) 932-4759
- NPI assigned
- Oct 12, 2011
- Last updated
- Oct 12, 2011
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 03230378 | OH | Primary |
Addresses
Primary practice location
3020 Mayfield Rd
Cleveland Heights, OH 44118
Mailing address
2685 Euclid Heights
Unit #1
Cleveland Heights, OH 44106
Phone (440) 241-0721
Other names 1
- Dr. Vladislav Tenenbaum
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 03230378 | OH | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Past | Accepting new patients | |
| Walgreen Co | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1318377600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1318377600000",
"number": "1205111077",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2685 EUCLID HEIGHTS",
"address_2": "UNIT #1",
"city": "CLEVELAND HEIGHTS",
"state": "OH",
"postal_code": "44106",
"telephone_number": "440-241-0721"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3020 MAYFIELD RD",
"city": "CLEVELAND HEIGHTS",
"state": "OH",
"postal_code": "44118",
"telephone_number": "216-932-4759"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TENENBAUM",
"first_name": "VLADISLAV",
"name_prefix": "Dr.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2011-10-12",
"last_updated": "2011-10-12",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "OH",
"license": "03230378",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "VLADISLAV",
"last_name": "TENENBAUM",
"prefix": "DR.",
"credential": "PHARMD",
"code": "2",
"type": "Professional Name"
}
]
}Other providers in Cleveland Heights, OH
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Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.