Provider Demographics
NPI:1255850244
Name:GORMLEY, TIFFANI LAURYN
Entity Type:Individual
Prefix:
First Name:TIFFANI
Middle Name:LAURYN
Last Name:GORMLEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:252 YOSEMITE DR
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15235-2047
Mailing Address - Country:US
Mailing Address - Phone:216-630-1781
Mailing Address - Fax:
Practice Address - Street 1:252 YOSEMITE DR
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15235-2047
Practice Address - Country:US
Practice Address - Phone:216-630-1781
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-09-12
Last Update Date:2024-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program