Provider Demographics
NPI:1437374410
Name:VOLPE, TIFFANY LYN (PT, DPT, COMT)
Entity Type:Individual
Prefix:
First Name:TIFFANY
Middle Name:LYN
Last Name:VOLPE
Suffix:
Gender:F
Credentials:PT, DPT, COMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1111 CLIFTON AVE STE 101
Mailing Address - Street 2:
Mailing Address - City:CLIFTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07013-3633
Mailing Address - Country:US
Mailing Address - Phone:973-400-3730
Mailing Address - Fax:
Practice Address - Street 1:1111 CLIFTON AVE STE 101
Practice Address - Street 2:
Practice Address - City:CLIFTON
Practice Address - State:NJ
Practice Address - Zip Code:07013-3633
Practice Address - Country:US
Practice Address - Phone:973-400-3730
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-16
Last Update Date:2014-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA01215000225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
705730OtherACN GROUP
NJ118776ZEL6Medicare PIN