Individual
MRS. TIFFANY ANNE EBEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1 ROBERT WOOD JOHNSON PL, NEW BRUNSWICK, NJ 08901
(818) 917-1261
Mailing address
11 RED HAWK RD N, COLTS NECK, NJ 07722-2013
(818) 917-1261
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
25MP00258500
NJ
Other
Enumeration date
07/19/2011
Last updated
07/24/2018
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