Provider Demographics
NPI:1417344391
Name:BURPO, TIFFINY (LPN)
Entity Type:Individual
Prefix:
First Name:TIFFINY
Middle Name:
Last Name:BURPO
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22 JENNIFER CT
Mailing Address - Street 2:
Mailing Address - City:POUGHKEEPSIE
Mailing Address - State:NY
Mailing Address - Zip Code:12601-6232
Mailing Address - Country:US
Mailing Address - Phone:845-275-2509
Mailing Address - Fax:
Practice Address - Street 1:22 JENNIFER CT
Practice Address - Street 2:
Practice Address - City:POUGHKEEPSIE
Practice Address - State:NY
Practice Address - Zip Code:12601-6232
Practice Address - Country:US
Practice Address - Phone:845-275-2509
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-04-18
Last Update Date:2015-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY306759-1164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse