Healthcare Provider Details

I. General information

NPI: 1609317874
Provider Name (Legal Business Name): THOMAS MICHAEL KAFFENBERGER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/20/2017
Last Update Date: 02/04/2024
Certification Date: 02/04/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1400 LOCUST ST STE 2100
PITTSBURGH PA
15219-5114
US

IV. Provider business mailing address

3600 FORBES AVE FORBES TOWER- PLAZA SUITE 140
PITTSBURGH PA
15213-3410
US

V. Phone/Fax

Practice location:
  • Phone: 412-232-3687
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License NumberMD481239
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code207YS0012X
TaxonomySleep Medicine (Otolaryngology) Physician
License NumberMD481239
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: