MEDICARE: JEFFERSON REGIONAL MEDICAL CENTER

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	101YP2500X	Professional Counselor
2	103T00000X	Psychologist
3	1041C0700X	Clinical Social Worker
4	2084P0800X	Psychiatry Physician

General Provider Information

NPI Number	:	1891763249
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JEFFERSON REGIONAL MEDICAL CENTER

Provider Business Mailing Address
First Line	:	810 CLAIRTON BLVD STE 500600
Second Line	:
City	:	PITTSBURGH
State	:	PA
Zip	:	15236-5505
Country	:	US
Telephone Number	:	412-650-1100
Fax Number	:	412-650-1101

Provider Business Practice Location Address
First Line	:	810 CLAIRTON BLVD STE 500600
Second Line	:
City	:	PITTSBURGH
State	:	PA
Zip	:	15236-5505
Country	:	US
Telephone Number	:	412-650-1100
Fax Number	:	412-650-1101

Authorized Official
Title or Position	:	DIRECTOR PROVIDER ENROLLMENT
Name	:	DENISE NOEL
Credential	:
Telephone Number	:	412-330-5861

Provider Enumeration Date	:	03/10/2006
Last Update Date	:	11/09/2020

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Directions to “JEFFERSON REGIONAL MEDICAL CENTER ” Practice Location

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