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NPI Code Detail

MEDICARE: TIFFANIE PARADISE AGNP

MEDICARE: TIFFANIE PARADISE AGNP
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
1363LA2200XAdult Health Nurse Practitioner310640NY

General Provider Information

NPI Number : 1902534811
Entity Type Code : Individual
Provider Name (Legal Business Name) : TIFFANIE PARADISE AGNP
Provider Business Mailing Address
First Line : 206 NORTH ST
Second Line :
City : BATAVIA
State : NY
Zip : 14020-1610
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 105 CANAL LANDING BLVD
Second Line :
City : ROCHESTER
State : NY
Zip : 14626-5107
Country : US
Telephone Number : 585-813-5962
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/09/2022
Last Update Date : 01/27/2026

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Directions to “ TIFFANIE PARADISE AGNP” Practice Location

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