Tieman, Mark Daryl
Tieman, Mark Daryl is an individual health care provider with primary practice located at 356 Veterans Memorial Hwy , Commack NY 11725-4332. He recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as his primary health care specialty. Tieman, Mark Daryl can be contacted via phone (631) 858-0400.Contact Information
Primary practice address
356 Veterans Memorial Hwy
Commack NY 11725-4332
Phone: (631) 858-0400
Fax: (631) 543-2785
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | 179172 | New York |
Profile Details
| NPI number | 1154494003 |
|---|---|
| LBN Legal business name | Tieman, Mark Daryl |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Nov 16th, 2006 |
| Last updated | Jul 8th, 2007 - about 17 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1154494003 | NPPES |
| New York | Other | 179172 | M.D. LICENSE NUMBER |
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