Provider Demographics
NPI:1093402596
Name:BUFFARDI, TIFFANY TUESDAY (LMSW)
Entity Type:Individual
Prefix:
First Name:TIFFANY
Middle Name:TUESDAY
Last Name:BUFFARDI
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:597 MIDDLE RD
Mailing Address - Street 2:
Mailing Address - City:BAYPORT
Mailing Address - State:NY
Mailing Address - Zip Code:11705-1925
Mailing Address - Country:US
Mailing Address - Phone:631-533-0708
Mailing Address - Fax:
Practice Address - Street 1:597 MIDDLE RD
Practice Address - Street 2:
Practice Address - City:BAYPORT
Practice Address - State:NY
Practice Address - Zip Code:11705-1925
Practice Address - Country:US
Practice Address - Phone:631-533-0708
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-24
Last Update Date:2023-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY109222104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker