Individual
ZACHARY TIFFANY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
602 IVY ST, ELMIRA, NY 14905-1646
(607) 737-4422
Mailing address
47 BEAVER AVE, BEAVER DAMS, NY 14812-9104
Taxonomy
Speciality
Code
Description
License number
State
163WW0000X
Wound Care Registered Nurse
Primary
799197
NY
Other
Enumeration date
09/27/2021
Last updated
09/27/2021
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