Provider Demographics
NPI:1134299894
Name:DUDA, TARA L (PT)
Entity Type:Individual
Prefix:MRS
First Name:TARA
Middle Name:L
Last Name:DUDA
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5141 BRIGHTWOOD RD
Mailing Address - Street 2:
Mailing Address - City:BETHEL PARK
Mailing Address - State:PA
Mailing Address - Zip Code:15102-2743
Mailing Address - Country:US
Mailing Address - Phone:412-831-1220
Mailing Address - Fax:412-831-1663
Practice Address - Street 1:5141 BRIGHTWOOD RD
Practice Address - Street 2:
Practice Address - City:BETHEL PARK
Practice Address - State:PA
Practice Address - Zip Code:15102-2743
Practice Address - Country:US
Practice Address - Phone:412-831-1220
Practice Address - Fax:412-831-1663
Is Sole Proprietor?:No
Enumeration Date:2006-11-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT013642L225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist