Provider Demographics
NPI:1255584363
Name:BROWN, TIFFANY J (OTD,OTR/L,ATP)
Entity type:Individual
Prefix:MS
First Name:TIFFANY
Middle Name:J
Last Name:BROWN
Suffix:
Gender:F
Credentials:OTD,OTR/L,ATP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11595 226TH ST
Mailing Address - Street 2:
Mailing Address - City:CAMBRIA HEIGHTS
Mailing Address - State:NY
Mailing Address - Zip Code:11411-1426
Mailing Address - Country:US
Mailing Address - Phone:718-528-5010
Mailing Address - Fax:
Practice Address - Street 1:11595 226TH ST
Practice Address - Street 2:
Practice Address - City:CAMBRIA HEIGHTS
Practice Address - State:NY
Practice Address - Zip Code:11411-1426
Practice Address - Country:US
Practice Address - Phone:718-528-5010
Practice Address - Fax:718-528-5010
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-03
Last Update Date:2016-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY014364225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics