Alicemarie Tennyson | Middletown, NY • PECOS Search

Alicemarie Tennyson

Specialist

Other Service Providers

2277 Goshen Tpke, Middletown, NY 10941-4032

PECOS Enrollment

Based on the most recent information from CMS, provider Alicemarie Tennyson does not have current enrollment records in PECOS.

Part B
Medicare Part B
Not Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Not Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records 5 days ago.

Profile Details

Provider ID
1932461993
Provider Type
Individual
Full Name
Tennyson, Alicemarie
Gender
Female

Sole Proprietor
No
Enumeration Date
6/14/2012
Last Updated
6/14/2012

Contact Information

Practice Location

2277 Goshen Tpke, Middletown, NY 10941-4032

Unlisted Fax

Mailing Location

2277 Goshen Tpke, Middletown, NY 10941-4032

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 174400000X Primary	Description Specialist Other Service Providers	License Unlisted Issuer