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General NPI Number Information
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NPI Number | 1972764819
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Entity Type | Individual
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Provider Name | TIFFANI LEIGH MCDONOUGH MD
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Gender | Female
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Dates
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Enumeration Date | 06/23/2008
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Last Update Date | 07/16/2025
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Provider Practice Location Address
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Address Line | 75 PRINGLE WAY STE 505
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City | RENO
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State | NV
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Zip | 89502-1469
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Country | US
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Telephone | 775-982-5437
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Fax |
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Provider Business Mailing Address
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Address Line | 92 CAMPUS DR STE B
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City | SCARBOROUGH
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State | ME
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Zip | 04074-7229
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Country | US
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Telephone | 207-885-4362
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Fax | 212-342-6865
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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 | 2084E0001X
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Taxonomy Name | Epilepsy Physician
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License Number | MD25926
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License Number State | ME
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Taxonomy #2
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Taxonomy Code | 2084N0402X
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Taxonomy Name | Neurology with Special Qualifications in Child Neurology Physician
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License Number | 255224
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License Number State | NY
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Taxonomy #3
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Taxonomy Code | 2084N0402X
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Taxonomy Name | Neurology with Special Qualifications in Child Neurology Physician
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License Number | MD25926
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License Number State | ME
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Taxonomy #4
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Taxonomy Code | 2084N0402X
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Taxonomy Name | Neurology with Special Qualifications in Child Neurology Physician
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License Number | 27260
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License Number State | NV
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