Provider Demographics
NPI:1508046731
Name:ECHELMEIER, TIERNEY P (RN)
Entity Type:Individual
Prefix:MS
First Name:TIERNEY
Middle Name:P
Last Name:ECHELMEIER
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:713 WILLOW AVE
Mailing Address - Street 2:APT 1 F
Mailing Address - City:HOBOKEN
Mailing Address - State:NJ
Mailing Address - Zip Code:07030-4024
Mailing Address - Country:US
Mailing Address - Phone:484-410-1017
Mailing Address - Fax:201-526-4900
Practice Address - Street 1:40 W 77TH ST
Practice Address - Street 2:APT 7 E
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10024-5128
Practice Address - Country:US
Practice Address - Phone:484-410-1017
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-05
Last Update Date:2007-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY557575163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse