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General NPI Number Information
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NPI Number | 1386605921
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Entity Type | Individual
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Provider Name | FORTUNATA T TIENG MD
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Gender | Female
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Dates
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Enumeration Date | 03/31/2006
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Last Update Date | 08/25/2015
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Provider Practice Location Address
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Address Line | 91 MAIN ST
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City | PATERSON
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State | NJ
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Zip | 07505-1026
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Country | US
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Telephone | 973-278-3800
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Fax |
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Provider Business Mailing Address
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Address Line | 91 MAIN ST
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City | PATERSON
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State | NJ
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Zip | 07505-1026
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Country | US
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Telephone | 973-278-3800
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | MA32875
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License Number State | NJ
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