Individual
TIFFANY M GREENE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
8423 MARKET ST STE 205, BOARDMAN, OH 44512-6778
(330) 965-5490
(330) 965-5491
Mailing address
8423 MARKET ST STE 205, BOARDMAN, OH 44512-6778
(330) 965-5490
(330) 965-5491
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
50.003400RX
OH
363AS0400X
Surgical Physician Assistant
50003400
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0067385
—
OH
Enumeration date
09/20/2011
Last updated
04/08/2026
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