Provider Demographics
NPI:1912095514
Name:SMITH, TANIS BEATRICE
Entity type:Individual
Prefix:MRS
First Name:TANIS
Middle Name:BEATRICE
Last Name:SMITH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:958 GARDEN CITY DR
Mailing Address - Street 2:
Mailing Address - City:MONROEVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:15146-1130
Mailing Address - Country:US
Mailing Address - Phone:412-374-8887
Mailing Address - Fax:
Practice Address - Street 1:958 GARDEN CITY DR
Practice Address - Street 2:
Practice Address - City:MONROEVILLE
Practice Address - State:PA
Practice Address - Zip Code:15146-1130
Practice Address - Country:US
Practice Address - Phone:412-374-8887
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist