Provider Demographics
NPI:1740459171
Name:TRIEBSCH, MATTHEW DENNIS (MSE, ATC, CSCS)
Entity type:Individual
Prefix:MR
First Name:MATTHEW
Middle Name:DENNIS
Last Name:TRIEBSCH
Suffix:
Gender:M
Credentials:MSE, ATC, CSCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3400 S PARK RD
Mailing Address - Street 2:
Mailing Address - City:BETHEL PARK
Mailing Address - State:PA
Mailing Address - Zip Code:15102-1150
Mailing Address - Country:US
Mailing Address - Phone:412-831-1333
Mailing Address - Fax:
Practice Address - Street 1:3400 S PARK RD
Practice Address - Street 2:
Practice Address - City:BETHEL PARK
Practice Address - State:PA
Practice Address - Zip Code:15102-1150
Practice Address - Country:US
Practice Address - Phone:412-831-1333
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-29
Last Update Date:2018-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PART0032702255A2300X
PARP450013183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
No2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer