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Organization

NORTHEAST ORTHOPEDIC ASSOCIATES, PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. JOHN J TIERNEY DO (PRESIDENT)
(781) 461-4543
Entity
Organization

Contact information

Practice address
200 PROVIDENCE HWY, SUITE 202, DEDHAM, MA 02026-1881
(781) 461-4543
(781) 326-2030
Mailing address
PO BOX 415044, BOSTON, MA 02241-5044
(781) 407-7713
(781) 407-0998

Taxonomy

Speciality
Code
Description
License number
State
207XS0114X
Adult Reconstructive Orthopaedic Surgery Physician
Primary
MA
207XX0004X
Orthopaedic Foot and Ankle Surgery Physician
MA
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
MA
208100000X
Physical Medicine & Rehabilitation Physician
MA
2081P2900X
Pain Medicine (Physical Medicine & Rehabilitation) Physician
MA
213E00000X
Podiatrist
MA
213ES0000X
Sports Medicine Podiatrist
MA
213ES0131X
Foot Surgery Podiatrist
MA

Other

Enumeration date
05/20/2006
Last updated
10/11/2007
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