Provider Demographics
NPI:1427939123
Name:TWIN WINGS MEDICAL PC
Entity type:Organization
Organization Name:TWIN WINGS MEDICAL PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:DOV
Authorized Official - Last Name:TENNENBERG
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:248-408-7299
Mailing Address - Street 1:1021 NEILSON ST APT 1
Mailing Address - Street 2:
Mailing Address - City:FAR ROCKAWAY
Mailing Address - State:NY
Mailing Address - Zip Code:11691-5039
Mailing Address - Country:US
Mailing Address - Phone:347-461-8204
Mailing Address - Fax:
Practice Address - Street 1:109 1/2 MAIN ST E
Practice Address - Street 2:
Practice Address - City:SLEEPY EYE
Practice Address - State:MN
Practice Address - Zip Code:56085-1352
Practice Address - Country:US
Practice Address - Phone:347-461-8204
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-09-09
Last Update Date:2025-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty