Healthcare Provider Details

I. General information

NPI: 1417865270
Provider Name (Legal Business Name): TIFFANY M MILTON LMT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/31/2026
Last Update Date: 08/31/2026
Certification Date: 08/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

828 HEMPSTEAD TPKE
FRANKLIN SQUARE NY
11010-4341
US

IV. Provider business mailing address

17042 118TH RD
JAMAICA NY
11434-2246
US

V. Phone/Fax

Practice location:
  • Phone: 516-505-8360
  • Fax:
Mailing address:
  • Phone: 347-357-4519
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number026450
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: