Individual
MATTHEW R TIEDE I
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
525 E 68TH ST, BOX 130, RM M-528, NEW YORK, NY 10065-4870
(610) 716-1687
Mailing address
537 S WATERLOO RD, DEVON, PA 19333-1729
(610) 716-1687
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
—
—
Other
Enumeration date
04/28/2008
Last updated
04/28/2008
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