Individual
MS. LOIS TIETJEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
35 LONGWOOD RD, MIDDLE ISLAND, NY 11953-2045
(631) 924-0008
Mailing address
143 EAGLE HILL CT, MIDDLE ISLAND, NY 11953-1609
(631) 504-6460
Taxonomy
Speciality
Code
Description
License number
State
174H00000X
Health Educator
Primary
—
—
Other
Enumeration date
02/01/2016
Last updated
02/01/2016
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