Provider Demographics
NPI:1255864781
Name:JAEGER, NICHOLAS RUBENSTEIN (MD)
Entity Type:Individual
Prefix:
First Name:NICHOLAS
Middle Name:RUBENSTEIN
Last Name:JAEGER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:JON
Other - Middle Name:NICHOLAS
Other - Last Name:RUBENSTEIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:4 ALLEGHENY CTR FL 7
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15212-5255
Mailing Address - Country:US
Mailing Address - Phone:412-216-4057
Mailing Address - Fax:
Practice Address - Street 1:4 ALLEGHENY CTR FL 7
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15212-5255
Practice Address - Country:US
Practice Address - Phone:412-216-4057
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-04-11
Last Update Date:2022-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0116030814390200000X
PAMD472510207ZP0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0101XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program