MEDICARE: GIANNINA TIERNEY M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208000000X	Pediatrics Physician	81805	MA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	000000029537	OTHER	MA	BOSTON HEALTH NET
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	201966	OTHER	MA	HARVARD PILGRIM
4	J31576	OTHER	MA	BLUE SHIELD
5	1201104	OTHER	MA	UNITED HEALTH PLAN
6	081804	OTHER	MA	TUFTS
7	7677991001	OTHER	MA	CIGNA

General Provider Information

NPI Number	:	1457311169
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GIANNINA TIERNEY M.D.

Provider Business Mailing Address
First Line	:	15 BRAMBLE BUSH DR
Second Line	:
City	:	FALMOUTH
State	:	MA
Zip	:	02540-2325
Country	:	US
Telephone Number	:	508-548-6989
Fax Number	:

Provider Business Practice Location Address
First Line	:	15 BRAMBLEBUSH PARK
Second Line	:
City	:	FALMOUTH
State	:	MA
Zip	:	02540-2325
Country	:	US
Telephone Number	:	508-548-6969
Fax Number	:	508-540-2793

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/25/2006
Last Update Date	:	05/26/2021

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Directions to “ GIANNINA TIERNEY M.D.” Practice Location

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