Provider Demographics
NPI:1942206347
Name:TIERNAN, JULIA C (MD)
Entity Type:Individual
Prefix:DR
First Name:JULIA
Middle Name:C
Last Name:TIERNAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:721 ARBOR WAY
Mailing Address - Street 2:SUITE 102
Mailing Address - City:BLUE BELL
Mailing Address - State:PA
Mailing Address - Zip Code:19422-1917
Mailing Address - Country:US
Mailing Address - Phone:215-643-0707
Mailing Address - Fax:
Practice Address - Street 1:721 ARBOR WAY
Practice Address - Street 2:SUITE 102
Practice Address - City:BLUE BELL
Practice Address - State:PA
Practice Address - Zip Code:19422-1917
Practice Address - Country:US
Practice Address - Phone:215-643-0707
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-06-22
Last Update Date:2014-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD417535207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA058503Medicare PIN