Victoria Tiedemann, DO

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

Practice address

42 E Laurel Rd Ste 2600
Stratford, NJ 08084-1354

Phone

(856) 566-6875

NPI assigned

Jun 14, 2020

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Osteopathy

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Rowan University School of Osteopathic Medicine

  • General Acute Care Hospital
  • Stratford, NJ
  • NPI 1083062616
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1592092800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1592092800000",
    "number": "1114542289",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "42 E LAUREL RD STE 2600",
            "city": "STRATFORD",
            "state": "NJ",
            "postal_code": "080841354"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "42 E LAUREL RD STE 2600",
            "city": "STRATFORD",
            "state": "NJ",
            "postal_code": "080841354",
            "telephone_number": "856-566-6875"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TIEDEMANN",
        "first_name": "VICTORIA",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-06-14",
        "last_updated": "2020-06-14",
        "certification_date": "2020-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jacob Bryce Thatcher, DO
• Chetna Thawani
• Ashley Thomas
• May A Thomas, M. D.
• Michael Ghattas Thomas, DO
• John Robert Tiffany
• Lloyd Tinianow, MD
• Nicholas James Tomasello, D.O.
• Isabella Torres
• Konstantinos Totolos, MD

• Student in an Organized Health Care Education/Training Program in Stratford, NJ
• Providers in Stratford, NJ by specialty
• Student in an Organized Health Care Education/Training Program in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.