Healthcare Provider Details

I. General information

NPI: 1396191250
Provider Name (Legal Business Name): TINA ZIFF OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/10/2016
Last Update Date: 04/28/2023
Certification Date: 04/28/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

107 BROADVIEW RD
SPRINGFIELD PA
19064-1423
US

IV. Provider business mailing address

107 BROADVIEW RD
SPRINGFIELD PA
19064-1423
US

V. Phone/Fax

Practice location:
  • Phone: 610-416-8032
  • Fax:
Mailing address:
  • Phone: 610-416-8032
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License NumberOC012962
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License NumberOC012962
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: