Individual
DR. MATTHEW TREVOR TIFFANY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
301 E MAIN ST, BAY SHORE, NY 11706-8408
(631) 968-3000
Mailing address
32 BAY SHORE AVE, BAY SHORE, NY 11706-7917
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
AS0779441
NY
Other
Enumeration date
09/01/2011
Last updated
09/01/2011
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