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1184995268
TIFFANY WALLACE
BROOKLYN, NY
NPI
1184995268
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
163W00000X Registered Nurse
(Licence: NY 636824)
Enumeration Date
2012-01-20
Last Update Date
2015-01-31
Business Address
-- TIFFANY WALLACE
584 THOMAS S BOYLAND ST
BROOKLYN, NY 11212-5044
Phone number: 917-804-9969
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Mailing Address
-- TIFFANY WALLACE
584 THOMAS S BOYLAND ST
BROOKLYN, NY 11212-5044
Phone number: 917-804-9969
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