Individual
TIFFANY JOSEPHINE MATTIS-PABIFIO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
101 NICOLLS RD, STONY BROOK, NY 11794-1358
(631) 444-3655
Mailing address
321 CROSSWAYS PARK DR STE C, WOODBURY, NY 11797-2066
(516) 405-7100
Taxonomy
Speciality
Code
Description
License number
State
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
Primary
344081
NY
363LF0000X
Family Nurse Practitioner
344081
NY
Other
Enumeration date
02/18/2019
Last updated
05/10/2024
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