Individual
TIFFANY RANDAZZO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
300 COMMUNITY DR, MANHASSET, NY 11030-3816
(516) 562-2252
Mailing address
3584 ROGER DR, WANTAGH, NY 11793-2627
Taxonomy
Speciality
Code
Description
License number
State
363LG0600X
Gerontology Nurse Practitioner
Primary
F308307-1
NY
Other
Enumeration date
01/19/2018
Last updated
01/19/2018
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