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General NPI Number Information
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NPI Number | 1457863474
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Entity Type | Individual
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Provider Name | JACQUELINE M TIGHE FNP-BC
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Gender | Female
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Dates
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Enumeration Date | 10/31/2017
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Last Update Date | 10/31/2017
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Provider Practice Location Address
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Address Line | 9 METROTECH CTR
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City | BROOKLYN
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State | NY
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Zip | 11201-5431
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Country | US
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Telephone | 718-999-1858
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Fax |
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Provider Business Mailing Address
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Address Line | 55 SENECA AVE
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City | STATEN ISLAND
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State | NY
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Zip | 10301-4227
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Country | US
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Telephone | 718-981-4644
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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 | F341364-1
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License Number State | NY
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