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Organization
TIERRA MEDICAL LLC
Active
Organization
TIERRA MEDICAL LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL FRIDMAN (OWNER)
(215) 847-2929
Entity
Organization
Contact information
Practice address
831 MAIN AVE, PASSAIC, NJ 07055-8400
(862) 249-1333
(844) 892-1555
Mailing address
831 MAIN AVE, PASSAIC, NJ 07055-8400
(215) 847-2929
(844) 892-1555
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
208VP0000X
Pain Medicine Physician
—
—
Other
Enumeration date
07/19/2020
Last updated
09/14/2020
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