Individual
CHARLES TIENE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
18 W 27TH ST FL 4, NEW YORK, NY 10001-6904
(703) 864-7908
Mailing address
104 BEDFORD AVE APT 3R, BROOKLYN, NY 11249-1134
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
051846
NY
Other
Enumeration date
03/21/2024
Last updated
03/21/2024
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