Individual provider · Type 1 NPI

Matthew R. Tiede I, PA-C

Medical Physician Assistant · New York, NY

NPI number 1235304536 Active

Practice location

525 E 68th St, Box 130, Rm M-528
New York, NY 10065-4870

Call (610) 716-1687 Map

Mailing address

537 S Waterloo Rd
Devon, PA 19333-1729

Specialties and licenses

TaxonomyCodeLicense
Medical Physician Assistant Primary 363AM0700XNone listed

Medical Physician Assistant: Definition to come...

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About NPI 1235304536

Matthew R. Tiede I, PA-C's National Provider Identifier is 1235304536, issued on Apr 28, 2008. The primary taxonomy on file is Medical Physician Assistant (363AM0700X), and the practice location is in New York, NY. The record was last updated on Apr 28, 2008.