Basic Information
| Provider Information | |||||||||
| NPI: | 1194355883 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | GRIFFIN | ||||||||
| FirstName: | TIFFANY | ||||||||
| MiddleName: | KIERA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 171 E 109TH ST APT 2B | ||||||||
| Address2: | |||||||||
| City: | NEW YORK | ||||||||
| State: | NY | ||||||||
| PostalCode: | 100293633 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9172910182 | ||||||||
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| Practice Location | |||||||||
| Address1: | 2090 ADAM CLAYTON POWELL JR BLVD FL 4 | ||||||||
| Address2: | |||||||||
| City: | NEW YORK | ||||||||
| State: | NY | ||||||||
| PostalCode: | 100274941 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2125536708 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 01/22/2020 | ||||||||
| LastUpdateDate: | 01/22/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 01/22/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163W00000X | 750421-1 | NY | Y | Nursing Service Providers | Registered Nurse |
No ID Information.