Provider Demographics
NPI:1972645307
Name:TIFT, LOUISA MAE (MD)
Entity Type:Individual
Prefix:DR
First Name:LOUISA
Middle Name:MAE
Last Name:TIFT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3620 E TREMONT AVE
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10465-2038
Mailing Address - Country:US
Mailing Address - Phone:718-792-4700
Mailing Address - Fax:
Practice Address - Street 1:3620 E TREMONT AVE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10465-2038
Practice Address - Country:US
Practice Address - Phone:718-792-4700
Practice Address - Fax:718-792-1255
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-13
Last Update Date:2021-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY242339207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology