Individual
TIANI JAY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
14202 20TH AVE, FLUSHING, NY 11351
(347) 804-1057
(347) 542-5853
Mailing address
14202 20TH AVE, FLUSHING, NY 11351-3000
(347) 804-1057
(347) 542-5853
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
—
Other
Enumeration date
11/05/2015
Last updated
08/20/2018
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