Individual
PETER N TIFFANY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3 WOODLAND RD, SUITE 216, STONEHAM, MA 02180-1702
(781) 979-0661
Mailing address
3 WOODLAND RD, SUITE 216, STONEHAM, MA 02180-1702
(781) 979-0661
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
54056
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3119386
—
MA
01
—
340005509
RR MEDICARE
MA
01
—
J04258
BCBS
MA
Enumeration date
07/11/2006
Last updated
04/09/2013
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