MEDICARE: DR. THOMAS M JAFFE MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	174400000X	Specialist	MD062126L	PA
2	208800000X	Urology Physician	28328	WV
3	208800000X	Urology Physician	MD062126L	PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	15697636	OTHER	PA	CAQH
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1417956723
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. THOMAS M JAFFE MD

Provider Business Mailing Address
First Line	:	1307 FEDERAL ST STE 300
Second Line	:
City	:	PITTSBURGH
State	:	PA
Zip	:	15212-4769
Country	:	US
Telephone Number	:	412-281-1757
Fax Number	:	412-281-7274

Provider Business Practice Location Address
First Line	:	1307 FEDERAL ST STE 300
Second Line	:
City	:	PITTSBURGH
State	:	PA
Zip	:	15212-4769
Country	:	US
Telephone Number	:	412-281-1757
Fax Number	:	412-281-7274

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/19/2005
Last Update Date	:	05/04/2023

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