Provider Demographics
NPI:1396191250
Name:ZIFF, TINA (OTR/L)
Entity Type:Individual
Prefix:
First Name:TINA
Middle Name:
Last Name:ZIFF
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:107 BROADVIEW RD
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:PA
Mailing Address - Zip Code:19064-1423
Mailing Address - Country:US
Mailing Address - Phone:610-416-8032
Mailing Address - Fax:
Practice Address - Street 1:107 BROADVIEW RD
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:PA
Practice Address - Zip Code:19064-1423
Practice Address - Country:US
Practice Address - Phone:610-416-8032
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-05-10
Last Update Date:2023-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOC012962172V00000X, 225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
No172V00000XOther Service ProvidersCommunity Health Worker