Provider Demographics
NPI:1598161101
Name:KELLY, TIERNEY (VMD)
Entity Type:Individual
Prefix:DR
First Name:TIERNEY
Middle Name:
Last Name:KELLY
Suffix:
Gender:F
Credentials:VMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2080 GREENTREE RD
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15220-1403
Mailing Address - Country:US
Mailing Address - Phone:412-276-3311
Mailing Address - Fax:412-276-4097
Practice Address - Street 1:2080 GREENTREE RD
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15220-1403
Practice Address - Country:US
Practice Address - Phone:412-276-3311
Practice Address - Fax:412-276-4097
Is Sole Proprietor?:No
Enumeration Date:2014-11-10
Last Update Date:2014-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PABV011391174M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174M00000XOther Service ProvidersVeterinarian