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Individual

MISS JACQUELINE EILEEN TIERNEY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
ATC

Contact information

Practice address
1300 FRANKLIN AVE, GARDEN CITY, NY 11530-1886
(516) 663-1052
Mailing address
1300 FRANKLIN AVE, GARDEN CITY, NY 11530-1886

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
002892
NY

Other

Enumeration date
04/19/2019
Last updated
04/19/2019
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