Provider Demographics
NPI:1831513670
Name:ITALIANO, TIFFANY CATHERINE (BSN, RN)
Entity type:Individual
Prefix:MS
First Name:TIFFANY
Middle Name:CATHERINE
Last Name:ITALIANO
Suffix:
Gender:F
Credentials:BSN, RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9 BROWNSTONE WAY
Mailing Address - Street 2:APT 117
Mailing Address - City:ENGLEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:07631-1213
Mailing Address - Country:US
Mailing Address - Phone:201-906-8987
Mailing Address - Fax:
Practice Address - Street 1:9 BROWNSTONE WAY
Practice Address - Street 2:APT 117
Practice Address - City:ENGLEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07631-1213
Practice Address - Country:US
Practice Address - Phone:201-906-8987
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-02-14
Last Update Date:2014-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY520423-1163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse