Provider Demographics
NPI:1558972612
Name:GIORGIO, TIFFANY (LICENSED)
Entity Type:Individual
Prefix:
First Name:TIFFANY
Middle Name:
Last Name:GIORGIO
Suffix:
Gender:F
Credentials:LICENSED
Other - Prefix:MRS
Other - First Name:TIFFANY
Other - Middle Name:
Other - Last Name:GIORGIO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:ENERGY MEDICINE
Mailing Address - Street 1:8 ROOSEVELT AVE
Mailing Address - Street 2:
Mailing Address - City:PORT JEFFERSON STATION
Mailing Address - State:NY
Mailing Address - Zip Code:11776-3337
Mailing Address - Country:US
Mailing Address - Phone:631-764-7337
Mailing Address - Fax:
Practice Address - Street 1:8 ROOSEVELT AVE
Practice Address - Street 2:
Practice Address - City:PORT JEFFERSON STATION
Practice Address - State:NY
Practice Address - Zip Code:11776-3337
Practice Address - Country:US
Practice Address - Phone:631-764-7337
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-12
Last Update Date:2020-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist