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Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

MR. FREDERICK R. TIENCKEN, RPA-C

Active Sole Proprietor

MR. FREDERICK R. TIENCKEN, RPA-C is a Medical Physician Assistant healthcare provider located in RIDGEWOOD, New Jersey. NPI 1396053617 is currently active in the NPPES registry. Verify at CMS.

Medical Physician Assistant · RIDGEWOOD, NJ

Registration Details

NPI Number
1396053617
Provider Type
Individual
Gender
Male
NPI Issued
Sep 21, 2010 (15.864352779235 yrs)
Last Updated
Aug 21, 2025
Licenses
014271 (NY)
25MP00264400 (NJ)
Sole Proprietor
Yes

Practice Information

Address
1200 E RIDGEWOOD AVE STE 200
RIDGEWOOD, NJ, 074503937
Browse NJ providers · Browse ZIP 07450
Phone
2013278600
Fax
2013278225
Primary Specialty
Medical Physician Assistant
363AM0700X
Additional Specialty
Medical Physician Assistant

Other Medical Physician Assistant Providers in RIDGEWOOD, NJ

Name Credential NPI
MRS. FLORIANA RUDNER RPA-C 1376877878
MR. ANTHONY PACIONE PA-C 1861742579
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.