Provider Demographics
NPI:1740999713
Name:TIFFANY SMITH LLC
Entity type:Organization
Organization Name:TIFFANY SMITH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TIFFANY
Authorized Official - Middle Name:O
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:347-589-2615
Mailing Address - Street 1:1009 NORA DR
Mailing Address - Street 2:
Mailing Address - City:LINDEN
Mailing Address - State:NJ
Mailing Address - Zip Code:07036-1708
Mailing Address - Country:US
Mailing Address - Phone:347-589-2615
Mailing Address - Fax:
Practice Address - Street 1:1009 NORA DR
Practice Address - Street 2:
Practice Address - City:LINDEN
Practice Address - State:NJ
Practice Address - Zip Code:07036-1708
Practice Address - Country:US
Practice Address - Phone:347-589-2615
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-11-18
Last Update Date:2022-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WG0600XNursing Service ProvidersRegistered NurseGerontologyGroup - Single Specialty