Individual
TIFFANEY PANTOJA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
55 ELM ST, GLENS FALLS, NY 12801-3549
(518) 793-7273
(518) 798-5004
Mailing address
PO BOX 31094, HARTFORD, CT 06150-1094
(518) 952-8140
(518) 952-8287
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01420800
—
NY
Enumeration date
01/03/2011
Last updated
01/03/2011
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