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Organization

MARK TIEMAN, MD, PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. MARK DARYL TIEMAN MD (PRESIDENT)
(631) 424-9844
Entity
Organization

Contact information

Practice address
356 VETERANS MEMORIAL HWY, COMMACK, NY 11725-4343
(631) 858-0400
(631) 543-2785
Mailing address
34 COPPERDALE LN, HUNTINGTON, NY 11743-2523
(631) 424-9844
(631) 543-2785

Taxonomy

Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
179172
NY

Other

Enumeration date
11/03/2011
Last updated
11/03/2011
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