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NPI Code Detail

MEDICARE: DR. TIFFANY YOUNG HIGGINS M.D.

MEDICARE: DR. TIFFANY YOUNG HIGGINS M.D.
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
1390200000XStudent in an Organized Health Care Education/Training Program
2208000000XPediatrics Physician57497MN
3208000000XPediatrics Physician280044NY

General Provider Information

NPI Number : 1639457484
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. TIFFANY YOUNG HIGGINS M.D.
Provider Business Mailing Address
First Line : 1301 57TH ST
Second Line : MAIMONIDES PEDIATRIC PRIMARY CARE
City : BROOKLYN
State : NY
Zip : 11219-4636
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1301 57TH ST
Second Line : MAIMONIDES PEDIATRIC PRIMARY CARE
City : BROOKLYN
State : NY
Zip : 11219-4636
Country : US
Telephone Number : 718-283-3662
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/28/2011
Last Update Date : 05/25/2016

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