1780669010 NPI number — JENNIFER F HOULIAHN P.A.

Table of content: JENNIFER F HOULIAHN P.A. (NPI 1780669010)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1780669010 NPI number — JENNIFER F HOULIAHN P.A.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HOULIAHN
Provider First Name:
JENNIFER
Provider Middle Name:
F
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
P.A.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1780669010
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
300 HALKET ST
Provider Second Line Business Mailing Address:
RENAISSANCE ORTHOPAEDICS, SUITE 1601
Provider Business Mailing Address City Name:
PITTSBURGH
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
15213-3108
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
412-683-7272
Provider Business Mailing Address Fax Number:
412-683-0341

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
300 HALKET ST
Provider Second Line Business Practice Location Address:
RENAISSANCE ORTHOPAEDICS, SUITE 1601
Provider Business Practice Location Address City Name:
PITTSBURGH
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15213-3108
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
412-683-7272
Provider Business Practice Location Address Fax Number:
412-683-0341
Provider Enumeration Date:
12/09/2005

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363AM0700X , with the licence number:  MA052133 , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)