MEDICARE: MS. TIFFANY POMPA 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
1	207RH0003X	Hematology & Oncology Physician	25MA09869800	NJ
2	207RX0202X	Medical Oncology Physician	25MA09869800	NJ
3	207RH0000X	Hematology (Internal Medicine) Physician	25MA09869800	NJ

General Provider Information

NPI Number	:	1649558586
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. TIFFANY POMPA M.D.

Provider Business Mailing Address
First Line	:	475 SEAVIEW AVE
Second Line	:
City	:	STATEN ISLAND
State	:	NY
Zip	:	10305-3436
Country	:	US
Telephone Number	:	917-741-5267
Fax Number	:

Provider Business Practice Location Address
First Line	:	210 S SHORE RD STE 106
Second Line	:
City	:	MARMORA
State	:	NJ
Zip	:	08223-1271
Country	:	US
Telephone Number	:	609-390-7888
Fax Number	:	609-390-2614

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

Provider Enumeration Date	:	07/26/2011
Last Update Date	:	05/20/2024

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