Provider Demographics
NPI:1932562634
Name:HOLMES, TIFFANY (DO)
Entity Type:Individual
Prefix:MRS
First Name:TIFFANY
Middle Name:
Last Name:HOLMES
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:41 UNIVERSITY DR STE 106
Mailing Address - Street 2:
Mailing Address - City:NEWTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18940-1873
Mailing Address - Country:US
Mailing Address - Phone:610-772-6889
Mailing Address - Fax:
Practice Address - Street 1:1503 LANSDOWNE AVE STE 3001
Practice Address - Street 2:
Practice Address - City:DARBY
Practice Address - State:PA
Practice Address - Zip Code:19023-1306
Practice Address - Country:US
Practice Address - Phone:610-586-4100
Practice Address - Fax:610-586-4114
Is Sole Proprietor?:No
Enumeration Date:2016-03-30
Last Update Date:2022-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOT017267207R00000X
PAOS022396207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine