Provider Demographics
NPI:1689331217
Name:VALENTIN, TIFFANI
Entity Type:Individual
Prefix:
First Name:TIFFANI
Middle Name:
Last Name:VALENTIN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1952 US HIGHWAY
Mailing Address - Street 2:
Mailing Address - City:EAST BOUND BROOK
Mailing Address - State:NJ
Mailing Address - Zip Code:08808
Mailing Address - Country:US
Mailing Address - Phone:201-563-3618
Mailing Address - Fax:
Practice Address - Street 1:1952 US HIGHWAY EAST
Practice Address - Street 2:
Practice Address - City:BOUND BROOK
Practice Address - State:NJ
Practice Address - Zip Code:08808
Practice Address - Country:US
Practice Address - Phone:201-563-3618
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-11-18
Last Update Date:2021-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician