Most Relevant Information
Provider Data
| NPI Number: | 1003243403 |
| Provider Name: | TIFFANY PEARSON |
| Entity Type: | Individual |
| Taxonomy Code: | 174400000X |
| Specialty: | Specialist |
| License Number: |
Most Important Dates
| Enumeration Date: | 09/30/2013 |
| Last Updated: | 08/23/2022 |
Provider Practice Location
810 BAYVIEW AVE
AMITYVILLE
NY
117012033
Practice Location Phone/Fax
| Phone: | 5167821010 |
| Fax: |
Provider Mailing Location
810 BAYVIEW AVE
AMITYVILLE
NY
117012033
Provider Mailing Phone/Fax
| Phone: | 5167821010 |
| Fax: |