Provider Demographics
NPI:1760758494
Name:JEWISH ASSOCIATION ON AGING
Entity Type:Organization
Organization Name:JEWISH ASSOCIATION ON AGING
Other - Org Name:JAA OUTPATIENT SERVICES
Other - Org Type:Other Name
Authorized Official - Title/Position:CHIEF OPERATING OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:E
Authorized Official - Last Name:GRITZER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:412-521-1011
Mailing Address - Street 1:200 JHF DR
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15217-2950
Mailing Address - Country:US
Mailing Address - Phone:412-421-7403
Mailing Address - Fax:
Practice Address - Street 1:200 JHF DR
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15217-2950
Practice Address - Country:US
Practice Address - Phone:412-421-7403
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:JEWISH ASSOCIATION ON AGING
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2012-03-27
Last Update Date:2020-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA396848305S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305S00000XManaged Care OrganizationsPoint of Service
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA396848Medicare Oscar/Certification