National Provider Identifier

Tiffany Mary Renae Porter

Tiffany Mary Renae Porter is listed in the NPPES registry with a primary specialty of Peer Specialist in Warsaw, NY and a listed phone number of (585) 219-3654.

NPI 1083209621Warsaw, NYPeer Specialist

Profile Overview

NPI
1083209621
Provider Type
Individual
Primary Specialty
Peer Specialist
Enumeration Date
March 05, 2021
Last Updated
March 05, 2021

Practice Location

  • 96 W Buffalo St
  • Warsaw, NY 14569-1210

Phone: (585) 219-3654

Specialties

  • Peer Specialist (175T00000X)
Full Record
NPI
1083209621
Entity Type
Individual
Last Name
Porter
First Name
Tiffany
Middle Name
Mary Renae
Mailing Street Address
96 W Buffalo St
Mailing City
Warsaw
Mailing State
NY
Mailing ZIP Code
14569-1210
Mailing Country
US
Mailing Phone
(585) 219-3654
Practice Street Address
96 W Buffalo St
Practice City
Warsaw
Practice State
NY
Practice ZIP Code
14569-1210
Practice Country
US
Practice Phone
(585) 219-3654
Enumeration Date
March 05, 2021
Last Updated
March 05, 2021
Sex
Female
Sole Proprietor
No
Certification Date
March 05, 2021
updated_by_file
npidata_pfile_20050523-20260308.csv
Taxonomies
Peer Specialist (175T00000X)