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General NPI Number Information
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NPI Number | 1013236017
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Entity Type | Individual
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Provider Name | DAVID P JEDLICKA AU.D.
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Gender | Male
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Dates
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Enumeration Date | 06/01/2010
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Last Update Date | 06/01/2010
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Provider Practice Location Address
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Address Line | 7180 HIGHLAND DR BUILDING 2, AUDIOLOGY, 132 A-H
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City | PITTSBURGH
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State | PA
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Zip | 15206-1206
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Country | US
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Telephone | 412-954-4647
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Fax |
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Provider Business Mailing Address
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Address Line | 1155 PROSPECT RD
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City | EVANS CITY
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State | PA
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Zip | 16033-3919
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Country | US
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Telephone | 724-822-6356
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Fax | 412-954-4630
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 231H00000X
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Taxonomy Name | Audiologist
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License Number | AT006158
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License Number State | PA
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