Healthcare Provider Details

I. General information

NPI: 1861326605
Provider Name (Legal Business Name): TIFFANY L SALMON NP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/09/2026
Last Update Date: 06/09/2026
Certification Date: 06/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10814 72ND AVE STE 4
FOREST HILLS NY
11375-5301
US

IV. Provider business mailing address

10814 72ND AVE STE 4
FOREST HILLS NY
11375-5301
US

V. Phone/Fax

Practice location:
  • Phone: 718-520-8480
  • Fax:
Mailing address:
  • Phone: 718-520-8480
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number357009
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: