Provider Demographics
NPI:1710328281
Name:TIEN, ALICE M (PHARMD)
Entity Type:Individual
Prefix:
First Name:ALICE
Middle Name:M
Last Name:TIEN
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:939 YORK RD
Mailing Address - Street 2:
Mailing Address - City:TOWSON
Mailing Address - State:MD
Mailing Address - Zip Code:21204-2514
Mailing Address - Country:US
Mailing Address - Phone:410-823-8790
Mailing Address - Fax:410-823-8796
Practice Address - Street 1:939 YORK RD
Practice Address - Street 2:
Practice Address - City:TOWSON
Practice Address - State:MD
Practice Address - Zip Code:21204-2514
Practice Address - Country:US
Practice Address - Phone:410-823-8790
Practice Address - Fax:410-823-8796
Is Sole Proprietor?:No
Enumeration Date:2013-07-12
Last Update Date:2013-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD19343183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist