Provider Demographics
NPI:1629367677
Name:BROWN, TIFFANY S (DPT)
Entity Type:Individual
Prefix:
First Name:TIFFANY
Middle Name:S
Last Name:BROWN
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1850 OCEAN PKWY
Mailing Address - Street 2:APT B6
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11223-3060
Mailing Address - Country:US
Mailing Address - Phone:713-724-4052
Mailing Address - Fax:
Practice Address - Street 1:1312 38TH ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11218-3612
Practice Address - Country:US
Practice Address - Phone:718-686-3700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-03-30
Last Update Date:2011-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY033422-1225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist