Individual
MARY TIERNEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
12 KNOLL TREE RD, ITHACA, NY 14850-9603
(607) 216-8720
Mailing address
12 KNOLL TREE RD, ITHACA, NY 14850-9603
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
001137-01
NY
Other
Enumeration date
10/24/2025
Last updated
10/24/2025
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