Healthcare Provider Details

I. General information

NPI: 1881402485
Provider Name (Legal Business Name): TIFFANY Y OHR
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/28/2024
Last Update Date: 12/28/2024
Certification Date: 12/27/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

VB 360A 3500 VICTORIA ST
PITTSBURGH PA
15261-0001
US

IV. Provider business mailing address

115 E 9TH AVE APT 305
HOMESTEAD PA
15120-1748
US

V. Phone/Fax

Practice location:
  • Phone: 301-960-8735
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN796614
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: