Individual
MRS. ALYSSA ANN TIEDEMANN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
95 BRADHURST AVE, VALHALLA, NY 10595-1637
(914) 592-7555
Mailing address
139 DOGWOOD RD, CORTLANDT MANOR, NY 10567-1209
(914) 400-5557
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
616890
NY
Other
Enumeration date
07/16/2012
Last updated
07/16/2012
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