MEDICARE: TIFFINI MARI REEDY N.P.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LA2200X	Adult Health Nurse Practitioner	RN2267821	MA
2	363LG0600X	Gerontology Nurse Practitioner	RN2267821	MA

General Provider Information

NPI Number	:	1891128708
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TIFFINI MARI REEDY N.P.

Provider Business Mailing Address
First Line	:	888 PURCHASE ST UNIT 1
Second Line	:
City	:	NEW BEDFORD
State	:	MA
Zip	:	02740-6233
Country	:	US
Telephone Number	:	508-542-7952
Fax Number	:

Provider Business Practice Location Address
First Line	:	888 PURCHASE ST UNIT 1
Second Line	:
City	:	NEW BEDFORD
State	:	MA
Zip	:	02740-6233
Country	:	US
Telephone Number	:	508-542-7952
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/14/2013
Last Update Date	:	08/14/2013

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