Individual
DR. TIFFANY BROOK REAVIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
150 55TH ST, BROOKLYN, NY 11220-2508
(909) 636-6497
Mailing address
150 55TH ST, BROOKLYN, NY 11220-2508
(909) 636-6497
Taxonomy
Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
OP 60329393
WA
208200000X
Plastic Surgery Physician
OS 12793
FL
2082S0105X
Surgery of the Hand (Plastic Surgery) Physician
259626
NY
208600000X
Surgery Physician
005932
AZ
208600000X
Surgery Physician
259626
NY
208600000X
Surgery Physician
OP 60329393
WA
208600000X
Surgery Physician
OS 12793
FL
2086S0127X
Trauma Surgery Physician
005932
AZ
2086S0127X
Trauma Surgery Physician
Primary
259626
NY
2086S0127X
Trauma Surgery Physician
OS 12793
FL
Other
Enumeration date
02/03/2011
Last updated
09/02/2016
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