Healthcare Provider Details

I. General information

NPI: 1780330530
Provider Name (Legal Business Name): JAMIE COHEN PEVEN PHD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/01/2022
Last Update Date: 01/23/2024
Certification Date: 01/23/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1010 DELAFIELD RD
PITTSBURGH PA
15240-1005
US

IV. Provider business mailing address

1010 DELAFIELD RD
PITTSBURGH PA
15240-1005
US

V. Phone/Fax

Practice location:
  • Phone: 412-822-3386
  • Fax:
Mailing address:
  • Phone: 412-822-2000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103G00000X
TaxonomyClinical Neuropsychologist
License NumberPS019520
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPS019520
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: