Provider Demographics
NPI:1285644062
Name:NASROLLAH JAHDI, M.D.
Entity Type:Organization
Organization Name:NASROLLAH JAHDI, M.D.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:NASROLLAH
Authorized Official - Middle Name:
Authorized Official - Last Name:JAHDI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:724-266-7900
Mailing Address - Street 1:PO BOX 369
Mailing Address - Street 2:
Mailing Address - City:SEWICKLEY
Mailing Address - State:PA
Mailing Address - Zip Code:15143-0369
Mailing Address - Country:US
Mailing Address - Phone:724-266-7900
Mailing Address - Fax:
Practice Address - Street 1:751 MERCHANT ST
Practice Address - Street 2:
Practice Address - City:AMBRIDGE
Practice Address - State:PA
Practice Address - Zip Code:15003-2457
Practice Address - Country:US
Practice Address - Phone:724-266-7900
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-08
Last Update Date:2007-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD028222E207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA001071983000Medicaid
OH2006322Medicaid