Provider Demographics
NPI:1447081427
Name:JOHNSON, TIFFANY NORA (CM)
Entity type:Individual
Prefix:MS
First Name:TIFFANY
Middle Name:NORA
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:CM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2508 40TH AVE APT 3D
Mailing Address - Street 2:
Mailing Address - City:LONG ISLAND CITY
Mailing Address - State:NY
Mailing Address - Zip Code:11101-3880
Mailing Address - Country:US
Mailing Address - Phone:917-698-3792
Mailing Address - Fax:
Practice Address - Street 1:260 E 67TH ST STE B
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10065-6212
Practice Address - Country:US
Practice Address - Phone:212-629-2000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-12
Last Update Date:2024-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife