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Individual

TIFFANY S YOUNG

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
RN, CPNP-PC

Contact information

Practice address
1322 CORTELYOU RD, BROOKLYN, NY 11226-5604
(718) 213-4738
Mailing address
380 W ELM ST, BROCKTON, MA 02301-4150
(508) 468-4114

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
841192-01
NY
163W00000X
Registered Nurse
RN2348486
MA
363LP0200X
Pediatric Nurse Practitioner
Primary
F383507
NY

Other

Enumeration date
08/30/2022
Last updated
01/09/2023
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