Individual
TIFFANY KOON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
1127 MD RT 3 N # 104, GAMBRILLS, MD 21054-1715
(410) 988-2662
(410) 988-4553
Mailing address
1127 MD RT 3 N # 104, GAMBRILLS, MD 21054-1715
(410) 988-2662
(410) 988-4553
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
TA2446
MD
152W00000X
Optometrist
TUV007964-1
NY
Other
Enumeration date
06/07/2013
Last updated
08/12/2019
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