Individual
TIFFANY SHAUGHNESSY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PMHNP
Contact information
Practice address
109 W 27TH ST, NEW YORK, NY 10001-0265
(332) 206-6054
Mailing address
109 W 27TH ST RM 5S, NEW YORK, NY 10001-6208
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
719080-1
NY
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
403602
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
719080-1
RN LICENSE NUMBER
NY
Enumeration date
04/02/2021
Last updated
05/11/2026
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