Provider Demographics
NPI:1649558586
Name:POMPA, TIFFANY (MD)
Entity Type:Individual
Prefix:MS
First Name:TIFFANY
Middle Name:
Last Name:POMPA
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 1:475 SEAVIEW AVE
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10305-3436
Mailing Address - Country:US
Mailing Address - Phone:917-741-5267
Mailing Address - Fax:
Practice Address - Street 1:210 S SHORE RD STE 106
Practice Address - Street 2:
Practice Address - City:MARMORA
Practice Address - State:NJ
Practice Address - Zip Code:08223-1271
Practice Address - Country:US
Practice Address - Phone:609-390-7888
Practice Address - Fax:609-390-2614
Is Sole Proprietor?:No
Enumeration Date:2011-07-26
Last Update Date:2017-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA09869800207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology