Healthcare Provider Details

I. General information

NPI: 1316230881
Provider Name (Legal Business Name): TATIANA LEIBU, M.D., PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/17/2011
Last Update Date: 05/17/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

660 PELLIS RD SUITE 201
GREENSBURG PA
15601-4633
US

IV. Provider business mailing address

660 PELLIS RD SUITE 201
GREENSBURG PA
15601-4633
US

V. Phone/Fax

Practice location:
  • Phone: 724-837-9066
  • Fax: 724-837-9231
Mailing address:
  • Phone: 724-837-9066
  • Fax: 724-837-9231

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberMD058891L
License Number StatePA

VIII. Authorized Official

Name: DR. TATIANA LEIBU
Title or Position: OWNER
Credential: M.D.
Phone: 724-837-9066