TIERRA PETTWAY

Licensed Practical Nurse

Active Individual
NPI: 1073491783

Practice Address

53 ACADEMY ST
Patchogue, NY 11772

Phone: (516) 410-4896

Specialties

Specialty Code Primary License
Licensed Practical Nurse 164W00000X Yes 292164 (NY)

Frequently Asked Questions

NPI 1073491783 is the National Provider Identifier for TIERRA PETTWAY, a Licensed Practical Nurse provider located in Patchogue, NY. This NPI was enumerated on August 22, 2025.
TIERRA PETTWAY practices at 53 ACADEMY ST, Patchogue, NY 11772.

Quick Facts

NPI
1073491783
Type
Individual
Enumerated
Aug 22, 2025
Last Updated
Aug 22, 2025

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