Healthcare Provider Details
I. General information
NPI: 1295116978
Provider Name (Legal Business Name): JENNIFER L DAURIA M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 06/17/2015
Last Update Date: 07/27/2021
Certification Date: 07/27/2021
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3471 5TH AVE #1010
PITTSBURGH PA
15213-3215
US
IV. Provider business mailing address
3471 5TH AVE STE 1010
PITTSBURGH PA
15213-3221
US
V. Phone/Fax
- Phone: 412-605-3203
- Fax:
- Phone: 412-605-3245
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207X00000X |
| Taxonomy | Orthopaedic Surgery Physician |
| License Number | 282436 |
| License Number State | MA |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207X00000X |
| Taxonomy | Orthopaedic Surgery Physician |
| License Number | MT208064 |
| License Number State | PA |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207XS0106X |
| Taxonomy | Orthopaedic Hand Surgery Physician |
| License Number | MD469076 |
| License Number State | PA |
| # 4 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207X00000X |
| Taxonomy | Orthopaedic Surgery Physician |
| License Number | 469076 |
| License Number State | PA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: