Individual
TIFFANY JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
993 E 39TH ST, BROOKLYN, NY 11210-3507
(347) 395-9031
Mailing address
249 THOMAS S BOYLAND ST, APT 22C, BROOKLYN, NY 11233-4156
(347) 395-9031
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
823448
NY
Other
Enumeration date
09/09/2013
Last updated
09/09/2013
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