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Individual

ELIZABETH THIDEMANN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
725 CONCORD AVE STE 6100, CAMBRIDGE, MA 02138-1040
(617) 864-8822
(617) 491-4692
Mailing address
330 MOUNT AUBURN ST # 2, CAMBRIDGE, MA 02138-5597
(617) 864-8822

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
PA100051
MA
363AM0700X
Medical Physician Assistant
Primary
PA100051
MA

Other

Enumeration date
09/21/2022
Last updated
08/29/2024
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