Individual
TIFFANY MINTO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1180 6TH AVE, NEW YORK, NY 10036-8401
(917) 383-1870
Mailing address
1180 6TH AVE, NEW YORK, NY 10036-8401
(917) 383-1870
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
778364
NY
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
405218
NY
Other
Enumeration date
05/31/2022
Last updated
12/05/2024
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