Provider Demographics
NPI:1417561101
Name:TORRES, TIFFANY S
Entity Type:Individual
Prefix:MISS
First Name:TIFFANY
Middle Name:S
Last Name:TORRES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:143 GUYGRACE LN
Mailing Address - Street 2:
Mailing Address - City:WEBSTER
Mailing Address - State:NY
Mailing Address - Zip Code:14580-2231
Mailing Address - Country:US
Mailing Address - Phone:585-363-0349
Mailing Address - Fax:
Practice Address - Street 1:143 GUYGRACE LN
Practice Address - Street 2:
Practice Address - City:WEBSTER
Practice Address - State:NY
Practice Address - Zip Code:14580-2231
Practice Address - Country:US
Practice Address - Phone:585-363-0349
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-01
Last Update Date:2020-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health