Provider Demographics
NPI:1538833439
Name:SUHM, TIFFANI
Entity type:Individual
Prefix:
First Name:TIFFANI
Middle Name:
Last Name:SUHM
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9 EDWARD DR
Mailing Address - Street 2:
Mailing Address - City:WEST SAND LAKE
Mailing Address - State:NY
Mailing Address - Zip Code:12196-9789
Mailing Address - Country:US
Mailing Address - Phone:845-707-5522
Mailing Address - Fax:
Practice Address - Street 1:297 N BALLSTON AVE
Practice Address - Street 2:
Practice Address - City:SCOTIA
Practice Address - State:NY
Practice Address - Zip Code:12302-2427
Practice Address - Country:US
Practice Address - Phone:518-370-4700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-04
Last Update Date:2021-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist