Individual provider Active NPI

Tiffany Wang

  • Student in an Organized Health Care Education/Training Program
  • New York, NY
National Provider Identifier
1356091409
Registry record updated Mar 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
1468 Madison Ave BLDG 15TH
New York, NY 10029-6508
Phone
(212) 241-0440
NPI assigned
Mar 23, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 12, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X MD2025-0098 NM
Student in an Organized Health Care Education/Training Program 390200000X Primary

Addresses

Primary practice location

1468 Madison Ave BLDG 15TH
New York, NY 10029-6508

Mailing address

1468 Madison Ave BLDG 15TH
New York, NY 10029-6508

Other practice location 1

1 University of New Mexico
Msc08 4640
Albuquerque, NM 81731
Phone (505) 272-4814

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250602000838 NM Order and Referring Only - PathologyPractitioner - Pathology 4486163532

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1647993600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741737600000",
    "number": "1356091409",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1468 MADISON AVE BLDG 15TH",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100296508"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1468 MADISON AVE BLDG 15TH",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100296508",
            "telephone_number": "212-241-0440"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 University of New Mexico",
            "address_2": "MSC08 4640",
            "address_purpose": "LOCATION",
            "city": "Albuquerque",
            "state": "NM",
            "postal_code": "81731",
            "country_code": "US",
            "telephone_number": "505-272-4814",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WANG",
        "first_name": "TIFFANY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-03-23",
        "last_updated": "2025-03-12",
        "certification_date": "2025-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NM",
            "license": "MD2025-0098",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.