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NPI Code Detail

MEDICARE: MS. CHERYL BURNS TIERNAN PT

MEDICARE: MS. CHERYL BURNS TIERNAN PT
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
1225100000XPhysical Therapist004933CT

General Provider Information

NPI Number : 1194875062
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. CHERYL BURNS TIERNAN PT
Provider Business Mailing Address
First Line : 189 ALPS RD
Second Line :
City : BRANFORD
State : CT
Zip : 06405-4771
Country : US
Telephone Number : 203-481-6221
Fax Number : 203-483-1893
Provider Business Practice Location Address
First Line : 189 ALPS RD
Second Line :
City : BRANFORD
State : CT
Zip : 06405-4771
Country : US
Telephone Number : 203-481-6221
Fax Number : 203-483-1893
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/11/2007
Last Update Date : 07/08/2007

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