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General NPI Number Information
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NPI Number | 1033695358
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Entity Type | Individual
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Provider Name | TIFFANY YOLANDA PRIESTER NP
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Gender | Female
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Dates
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Enumeration Date | 07/19/2018
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Last Update Date | 11/14/2021
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Provider Practice Location Address
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Address Line | 135 ROCKMART AVE
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City | ELMONT
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State | NY
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Zip | 11003-1731
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Country | US
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Telephone | 516-354-5600
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Fax |
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Provider Business Mailing Address
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Address Line | 207 W CENTENNIAL AVE
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City | ROOSEVELT
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State | NY
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Zip | 11575-1928
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Country | US
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Telephone | 516-263-4264
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 343109
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License Number State | NY
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