Provider Demographics
NPI:1962755736
Name:FIORE, TIFFANY CAROLE (PA-C)
Entity type:Individual
Prefix:
First Name:TIFFANY
Middle Name:CAROLE
Last Name:FIORE
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:TIFFANY
Other - Middle Name:CAROLE
Other - Last Name:CARTER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:PO BOX 29008
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07101-9008
Mailing Address - Country:US
Mailing Address - Phone:201-845-9300
Mailing Address - Fax:201-845-9301
Practice Address - Street 1:10 FOREST AVE
Practice Address - Street 2:
Practice Address - City:PARAMUS
Practice Address - State:NJ
Practice Address - Zip Code:07652-5242
Practice Address - Country:US
Practice Address - Phone:201-845-9300
Practice Address - Fax:201-845-9301
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-18
Last Update Date:2019-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant