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General NPI Number Information
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NPI Number | 1235757931
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Entity Type | Individual
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Provider Name | TIFFANY ROSE MAGNO CRNA
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Gender | Female
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Dates
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Enumeration Date | 07/09/2020
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Last Update Date | 10/18/2022
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Provider Practice Location Address
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Address Line | ONE HEALTHY WAY
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City | OCEANSIDE
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State | NY
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Zip | 11572
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Country | US
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Telephone | 516-632-3000
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Fax |
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Provider Business Mailing Address
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Address Line | 7011 108TH ST APT 3K
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City | FLUSHING
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State | NY
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Zip | 11375-4406
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Country | US
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Telephone | 917-574-3484
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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 | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | 690698
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License Number State | NY
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