MEDICARE: MS. TIFFANY J BROWN OTD,OTR/L,ATP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225XP0200X	Pediatric Occupational Therapist	014364	NY

General Provider Information

NPI Number	:	1255584363
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. TIFFANY J BROWN OTD,OTR/L,ATP

Provider Business Mailing Address
First Line	:	11595 226TH ST
Second Line	:
City	:	CAMBRIA HEIGHTS
State	:	NY
Zip	:	11411-1426
Country	:	US
Telephone Number	:	718-528-5010
Fax Number	:

Provider Business Practice Location Address
First Line	:	11595 226TH ST
Second Line	:
City	:	CAMBRIA HEIGHTS
State	:	NY
Zip	:	11411-1426
Country	:	US
Telephone Number	:	718-528-5010
Fax Number	:	718-528-5010

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/03/2008
Last Update Date	:	10/07/2016

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