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NPI Code Detail

MEDICARE: RICHARD N TIEDEMANN MD, FACS

MEDICARE:   RICHARD N TIEDEMANN  MD, FACS
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
1208D00000XGeneral Practice PhysicianMA2503965900NJ
2207Q00000XFamily Medicine Physician25MA03965900NJ

General Provider Information

NPI Number : 1952394132
Entity Type Code : Individual
Provider Name (Legal Business Name) : RICHARD N TIEDEMANN MD, FACS
Provider Business Mailing Address
First Line : 1100 RAHWAY RD
Second Line :
City : SCOTCH PLAINS
State : NJ
Zip : 07076-3412
Country : US
Telephone Number : 908-625-8036
Fax Number : 908-754-5904
Provider Business Practice Location Address
First Line : 1100 RAHWAY RD
Second Line :
City : SCOTCH PLAINS
State : NJ
Zip : 07076-3412
Country : US
Telephone Number : 908-625-8036
Fax Number : 908-754-5904
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/24/2005
Last Update Date : 02/09/2017

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Directions to “ RICHARD N TIEDEMANN MD, FACS” Practice Location

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