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Organization
TIFFANY ANN AVON PSY D PC
Active
Organization
TIFFANY ANN AVON PSY D PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TIFFANY AVON PSYD (DIRECTOR)
(917) 887-2783
Entity
Organization
Contact information
Practice address
585 PLANDOME RD STE 105, MANHASSET, NY 11030-1971
(917) 887-2783
Mailing address
20 CANTERBURY LN, RIDGEFIELD, CT 06877-1102
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
020146
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
020146
LICENSE
NY
Enumeration date
08/29/2018
Last updated
05/20/2021
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