Tierra Medical LLC

NPI #1477161172 in Passaic, New Jersey

Provider Information

NPI Number: 1477161172
Entity Type: Organization
Organization Name: Tierra Medical LLC
Primary Specialty: Internal Medicine
Enumeration Date: Jul 19, 2020
Last Updated: Sep 14, 2020

Practice Location

Address: 831 MAIN AVE
City: Passaic
State: New Jersey
ZIP Code: 07055-8400
Phone: (862) 249-1333

Authorized Official

Name: MICHAEL FRIDMAN
Title: OWNER
Phone: (215) 847-2929

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Pain Medicine - Pain Medicine — Pain Medicine	208VP0000X
Internal Medicine	207R00000X	Primary

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