Provider Demographics
NPI:1972865319
Name:TIANI, CLEMENT G
Entity Type:Individual
Prefix:
First Name:CLEMENT
Middle Name:G
Last Name:TIANI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9316 PINEY BRANCH RD
Mailing Address - Street 2:205
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20903-2868
Mailing Address - Country:US
Mailing Address - Phone:202-553-7862
Mailing Address - Fax:
Practice Address - Street 1:9316 PINEY BRANCH RD
Practice Address - Street 2:205
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20903-2868
Practice Address - Country:US
Practice Address - Phone:202-553-7862
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-12
Last Update Date:2012-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide