Provider Demographics
NPI:1346683802
Name:TIU, CHERRY PIE (APN-BC)
Entity Type:Individual
Prefix:MS
First Name:CHERRY PIE
Middle Name:
Last Name:TIU
Suffix:
Gender:F
Credentials:APN-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:313 STATE ST STE 408
Mailing Address - Street 2:
Mailing Address - City:PERTH AMBOY
Mailing Address - State:NJ
Mailing Address - Zip Code:08861-4128
Mailing Address - Country:US
Mailing Address - Phone:732-442-8185
Mailing Address - Fax:732-442-8188
Practice Address - Street 1:313 STATE ST STE 408
Practice Address - Street 2:
Practice Address - City:PERTH AMBOY
Practice Address - State:NJ
Practice Address - Zip Code:08861-4128
Practice Address - Country:US
Practice Address - Phone:732-442-8185
Practice Address - Fax:732-442-8188
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-15
Last Update Date:2013-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ00429800363LA2200X, 363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health