Provider Demographics
NPI:1629639117
Name:CREWE-KUJAWSKI, TIFFANI (LPN)
Entity Type:Individual
Prefix:
First Name:TIFFANI
Middle Name:
Last Name:CREWE-KUJAWSKI
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 1:112 MEIGS ST
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14607-2035
Mailing Address - Country:US
Mailing Address - Phone:315-576-8718
Mailing Address - Fax:
Practice Address - Street 1:112 MEIGS ST
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14607-2035
Practice Address - Country:US
Practice Address - Phone:315-576-8718
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-25
Last Update Date:2019-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY333562164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse