Tietzen, Mara Ainsley

Tietzen, Mara Ainsley is an sole proprietor health care provider with primary practice located at 300 Longwood Ave , Boston MA 02115-5724. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Pediatrics, Allopathic & Osteopathic Physicians / Sports Medicine. Allopathic & Osteopathic Physicians / Sports Medicine is her primary health care specialty. Tietzen, Mara Ainsley can be contacted via phone (857) 218-4924.

Contact Information

Primary practice address
300 Longwood Ave Boston MA 02115-5724
Phone: (857) 218-4924
Fax: (617) 730-0683
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 41268 Zz
Allopathic & Osteopathic Physicians / Sports Medicine 2080S0010X 283657 Massachusetts

Profile Details

NPI number 1831720903
LBN Legal business name Tietzen, Mara Ainsley
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jan 28th, 2020
Last updated Jul 9th, 2021 - about 3 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.

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