Provider Demographics
NPI:1508058926
Name:HOWARD-KREIDER, TIFFANY N (DPT)
Entity Type:Individual
Prefix:
First Name:TIFFANY
Middle Name:N
Last Name:HOWARD-KREIDER
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:TIFFANY
Other - Middle Name:
Other - Last Name:HOWARD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT
Mailing Address - Street 1:2300 PLEASANT VALLEY RD
Mailing Address - Street 2:
Mailing Address - City:YORK
Mailing Address - State:PA
Mailing Address - Zip Code:17402-9627
Mailing Address - Country:US
Mailing Address - Phone:717-757-3537
Mailing Address - Fax:717-718-9701
Practice Address - Street 1:2112 HARRISBURG PIKE
Practice Address - Street 2:SUITE 321
Practice Address - City:LANCASTER
Practice Address - State:PA
Practice Address - Zip Code:17601-2644
Practice Address - Country:US
Practice Address - Phone:717-757-3537
Practice Address - Fax:717-718-9701
Is Sole Proprietor?:No
Enumeration Date:2007-08-10
Last Update Date:2016-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT016935225100000X, 225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1026542490001Medicaid
PA215157HDXMedicare PIN