Provider Demographics
NPI:1497822449
Name:TIENG, NELSON L (MD)
Entity Type:Individual
Prefix:DR
First Name:NELSON
Middle Name:L
Last Name:TIENG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1650 SELWYN AVE DEPT OF
Mailing Address - Street 2:MILSTEIN BLDG, SUITE 8C
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10457-7626
Mailing Address - Country:US
Mailing Address - Phone:646-257-0468
Mailing Address - Fax:
Practice Address - Street 1:1650 SELWYN AVE
Practice Address - Street 2:DEPT OF EMERGENCY MEDICINE, SUITE 8C
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10457-7626
Practice Address - Country:US
Practice Address - Phone:718-960-1400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-28
Last Update Date:2011-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY231219207P00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine