Tiffney A Malloy, TOD/HI
Individual provider Active NPI Specialist · Wyoming, NY
NPI 1144057258 · NPPES record last updated Sep 14, 2024
Key facts
- NPI
- 1144057258
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Specialist 174400000X
- Practice address
- 6 Main St
Wyoming, NY 14591-9702 - Phone
- (585) 763-1019
- NPI assigned
- Sep 14, 2024
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | Yes |
Addresses
Primary practice location
6 Main St
Wyoming, NY 14591-9702
Mailing address
79 Main St
Wyoming, NY 14591-9708
Phone (585) 664-4415
Other providers in Wyoming, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 14, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.