Provider Demographics
NPI:1942515515
Name:WASSERMAN, TIFFANY ARLETTE (MA CCC SLP)
Entity Type:Individual
Prefix:MRS
First Name:TIFFANY
Middle Name:ARLETTE
Last Name:WASSERMAN
Suffix:
Gender:F
Credentials:MA CCC SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:351 E 84TH ST
Mailing Address - Street 2:APT 12F
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10028-4423
Mailing Address - Country:US
Mailing Address - Phone:718-757-7051
Mailing Address - Fax:
Practice Address - Street 1:351 E 84TH ST
Practice Address - Street 2:APT 12F
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10028-4423
Practice Address - Country:US
Practice Address - Phone:718-757-7051
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-08
Last Update Date:2012-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY019744235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist