Provider Demographics
NPI:1588664155
Name:CELEBREZZE, JENNIFER U (MD)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:U
Last Name:CELEBREZZE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:JENNIFER
Other - Middle Name:A
Other - Last Name:UVENA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4815 LIBERTY AVENUE
Mailing Address - Street 2:SUITE GR59
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15224-2156
Mailing Address - Country:US
Mailing Address - Phone:412-578-3951
Mailing Address - Fax:412-578-1587
Practice Address - Street 1:4815 LIBERTY AVENUE
Practice Address - Street 2:SUITE GR59
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15224-2156
Practice Address - Country:US
Practice Address - Phone:412-578-3951
Practice Address - Fax:412-578-1587
Is Sole Proprietor?:No
Enumeration Date:2005-07-26
Last Update Date:2021-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD072882L207VM0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VM0101XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyMaternal & Fetal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV1810510000Medicaid
PA001837608Medicaid
OH0316125Medicaid
OH0316125Medicaid
PA0018376080003Medicaid