Provider Demographics
NPI:1174810980
Name:TENEYCK, ELIZABETH (CRNA)
Entity type:Individual
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First Name:ELIZABETH
Middle Name:
Last Name:TENEYCK
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Gender:F
Credentials:CRNA
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Mailing Address - Street 1:5000 BRITTONFIELD PKWY
Mailing Address - Street 2:PO BOX 2000
Mailing Address - City:EAST SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13057-9226
Mailing Address - Country:US
Mailing Address - Phone:315-362-5129
Mailing Address - Fax:315-362-5179
Practice Address - Street 1:736 IRVING AVE
Practice Address - Street 2:ANESTHESIA DEPT
Practice Address - City:SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13210-1687
Practice Address - Country:US
Practice Address - Phone:315-470-7828
Practice Address - Fax:315-470-5811
Is Sole Proprietor?:No
Enumeration Date:2011-06-30
Last Update Date:2011-06-30
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY563718367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered