Provider Demographics
NPI:1639457484
Name:YOUNG HIGGINS, TIFFANY (MD)
Entity Type:Individual
Prefix:DR
First Name:TIFFANY
Middle Name:
Last Name:YOUNG HIGGINS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1301 57TH ST
Mailing Address - Street 2:MAIMONIDES PEDIATRIC PRIMARY CARE
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11219-4636
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1301 57TH ST
Practice Address - Street 2:MAIMONIDES PEDIATRIC PRIMARY CARE
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11219-4636
Practice Address - Country:US
Practice Address - Phone:718-283-3662
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-07-28
Last Update Date:2016-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
MN57497208000000X
NY280044208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program