Provider Demographics
NPI:1538338728
Name:MARILYN C TIU MD LLC
Entity type:Organization
Organization Name:MARILYN C TIU MD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:MARILYN
Authorized Official - Middle Name:C
Authorized Official - Last Name:TIU
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:330-385-1477
Mailing Address - Street 1:15549 STATE ROUTE 170
Mailing Address - Street 2:UNIT # 10
Mailing Address - City:EAST LIVERPOOL
Mailing Address - State:OH
Mailing Address - Zip Code:43920-9216
Mailing Address - Country:US
Mailing Address - Phone:330-385-1477
Mailing Address - Fax:330-385-1485
Practice Address - Street 1:15549 STATE ROUTE 170
Practice Address - Street 2:UNIT # 10
Practice Address - City:EAST LIVERPOOL
Practice Address - State:OH
Practice Address - Zip Code:43920-9216
Practice Address - Country:US
Practice Address - Phone:330-385-1477
Practice Address - Fax:330-385-1485
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-21
Last Update Date:2010-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35071087208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty