Healthcare Provider Details

I. General information

NPI: 1053353466
Provider Name (Legal Business Name): TIFFANY J. KRAJICEK N.P.
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 06/11/2006
Last Update Date: 03/07/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

150 E 32ND ST
NEW YORK NY
10016-6024
US

IV. Provider business mailing address

150 E 32ND ST
NEW YORK NY
10016-6024
US

V. Phone/Fax

Practice location:
  • Phone: 212-447-5330
  • Fax: 212-889-7089
Mailing address:
  • Phone: 212-447-5330
  • Fax: 212-889-7089

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LX0001X
TaxonomyObstetrics & Gynecology Nurse Practitioner
License NumberF420729
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: