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

DR. MARA AINSLEY TIETZEN, MD

Active Sole Proprietor

DR. MARA AINSLEY TIETZEN, MD is a Sports Medicine (Pediatrics) healthcare provider located in BOSTON, Massachusetts. NPI 1831720903 is currently active in the NPPES registry. Verify at CMS.

Sports Medicine (Pediatrics) · BOSTON, MA

Registration Details

NPI Number
1831720903
Provider Type
Individual
Gender
Female
NPI Issued
Jan 28, 2020 (6.5509697573028 yrs)
Last Updated
Jul 9, 2021
Licenses
41268 (ZZ)
283657 (MA)
Sole Proprietor
Yes

Practice Information

Address
300 LONGWOOD AVE
BOSTON, MA, 021155724
Browse MA providers · Browse ZIP 02115
Phone
8572184924
Fax
6177300683
Primary Specialty
Sports Medicine (Pediatrics)
2080S0010X
Additional Specialty
Sports Medicine (Pediatrics)

Other Sports Medicine (Pediatrics) Providers in BOSTON, MA

Name Credential NPI
PETER K KRIZ MD 1881681310
DR. ANDREA STRACCIOLINI MD 1982642559
MRS. JOANA LOUISE FRASER M.D. 1801113220
SARAH S. JACKSON MD 1356603799
JEFFREY LO MD 1730506999
MS. KRISTIN WHITNEY M.D. 1467870097
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.