Healthcare Provider Details

I. General information

NPI: 1508878992
Provider Name (Legal Business Name): TIFFANY NATURAL PHARMACY INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/13/2006
Last Update Date: 09/25/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1115 SOUTH AVE W
WESTFIELD NJ
07090-1418
US

IV. Provider business mailing address

1115 SOUTH AVE W
WESTFIELD NJ
07090-1418
US

V. Phone/Fax

Practice location:
  • Phone: 908-233-2200
  • Fax: 908-233-3975
Mailing address:
  • Phone: 908-233-2200
  • Fax: 908-233-3975

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number28RS0057530000
License Number StateNJ

VIII. Authorized Official

Name: MR. BRIAN B PINTO
Title or Position: PHARMACIST-IN-CHARGE
Credential: R.PH.
Phone: 908-233-6985