Healthcare Provider Details

I. General information

NPI: 1457377715
Provider Name (Legal Business Name): JEFFERY P HEIN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/13/2006
Last Update Date: 09/16/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

210 OHIO RIVER BLVD
BADEN PA
15005-1914
US

IV. Provider business mailing address

210 OHIO RIVER BLVD
BADEN PA
15005-1914
US

V. Phone/Fax

Practice location:
  • Phone: 724-869-6002
  • Fax: 724-869-6005
Mailing address:
  • Phone: 724-869-6002
  • Fax: 724-869-6005

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberMD053811L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: