Provider Demographics
NPI:1184779787
Name:DERINGOR, TARA J (PT)
Entity type:Individual
Prefix:MRS
First Name:TARA
Middle Name:J
Last Name:DERINGOR
Suffix:
Gender:F
Credentials:PT
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Mailing Address - Street 1:1125 WIGHTMAN ST
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15217-1049
Mailing Address - Country:US
Mailing Address - Phone:412-521-4576
Mailing Address - Fax:412-421-0312
Practice Address - Street 1:5425 BAUM BLVD
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15232-1201
Practice Address - Country:US
Practice Address - Phone:412-365-6065
Practice Address - Fax:412-365-6060
Is Sole Proprietor?:No
Enumeration Date:2007-01-24
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
PA011637L225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist