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Individual

TIANNA STEPHENS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
165 N VILLAGE AVE STE 5, ROCKVILLE CENTRE, NY 11570-3701
(516) 766-0393
Mailing address
2 CENTRAL AVE, GLEN COVE, NY 11542-2905

Taxonomy

Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
NY

Other

Enumeration date
07/28/2020
Last updated
07/28/2020
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