Individual
MRS. MELISSA JANE TIEDEMANN
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
RPA-C
Contact information
Practice address
2750 MERRICK RD, BELLMORE, NY 11710-5720
(516) 409-2000
(516) 409-2720
Mailing address
2800 MARCUS AVE, NEW HYDE PARK, NY 11042-1113
(516) 622-6000
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
008301
NY
Other
Enumeration date
10/31/2005
Last updated
03/04/2016
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