| Doctor Name: | PETR LEONIDOVICH TSENOVOY |
| NPI Number: | 1558507178 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | MD |
| License Number: | 25MA09126700 |
| Business Practice Address: | 19 Mohawk Ave Norwood, NJ - 076482410 |
| Business Phone Number: | 2013923588 |
| Business Fax Number: | |
| Mailing Address: | 95 Grasslands Rd, New York Med College, Munger Pavilion, Room 253 VALHALLA |
| State: | NY |
| Postal Code: | 105951652 |
| Phone Number: | 9144938373 |
| Fax Number: | |
| NPI Enumeration Date: | 01/02/2009 |
| NPI Last Update Date: | 03/30/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 174400000X |
| License Number: | 25MA09126700 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NJ |
| Taxonomy Type: | Other Service Providers |
| Taxonomy Classification: | Specialist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |