Healthcare Provider Details

I. General information

NPI: 1477574234
Provider Name (Legal Business Name): JAY BERNARD HERMAN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/21/2006
Last Update Date: 03/24/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

532 S AIKEN AVE SUITE 210
PITTSBURGH PA
15232
US

IV. Provider business mailing address

532 S AIKEN AVE SUITE 210
PITTSBURGH PA
15232
US

V. Phone/Fax

Practice location:
  • Phone: 412-681-5433
  • Fax: 412-681-7321
Mailing address:
  • Phone: 412-681-5433
  • Fax: 412-681-7321

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208800000X
TaxonomyUrology Physician
License Number024103E
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: