Provider Demographics
NPI:1184491938
Name:STRAUB, TIFFANY DAWN (CPO)
Entity type:Individual
Prefix:
First Name:TIFFANY
Middle Name:DAWN
Last Name:STRAUB
Suffix:
Gender:F
Credentials:CPO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5382 HARDT RD
Mailing Address - Street 2:
Mailing Address - City:GIBSONIA
Mailing Address - State:PA
Mailing Address - Zip Code:15044-9165
Mailing Address - Country:US
Mailing Address - Phone:412-577-6266
Mailing Address - Fax:724-473-4576
Practice Address - Street 1:100 PERRY HWY UNIT 103
Practice Address - Street 2:
Practice Address - City:HARMONY
Practice Address - State:PA
Practice Address - Zip Code:16037-9200
Practice Address - Country:US
Practice Address - Phone:724-473-4575
Practice Address - Fax:724-473-4576
Is Sole Proprietor?:No
Enumeration Date:2023-12-11
Last Update Date:2023-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPO000153224P00000X
PAOH000016222Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224P00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersProsthetist
No222Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOrthotist