Provider Demographics
NPI:1538459698
Name:TOLIVER, TIFFANY ELIZABETH MARIE (MD)
Entity type:Individual
Prefix:DR
First Name:TIFFANY
Middle Name:ELIZABETH MARIE
Last Name:TOLIVER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:465 SOUTH ST STE E200
Mailing Address - Street 2:
Mailing Address - City:MORRISTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07960-6442
Mailing Address - Country:US
Mailing Address - Phone:973-829-4900
Mailing Address - Fax:
Practice Address - Street 1:1000 GALLOPING HILL RD STE 108
Practice Address - Street 2:
Practice Address - City:UNION
Practice Address - State:NJ
Practice Address - Zip Code:07083
Practice Address - Country:US
Practice Address - Phone:908-522-3730
Practice Address - Fax:908-688-3621
Is Sole Proprietor?:No
Enumeration Date:2011-04-11
Last Update Date:2019-11-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJ25MA09509400207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0415928Medicaid
NJ0415928Medicaid