Provider Demographics
NPI:1780669010
Name:HOULIAHN, JENNIFER F (PA)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:F
Last Name:HOULIAHN
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:300 HALKET ST
Mailing Address - Street 2:RENAISSANCE ORTHOPAEDICS, SUITE 1601
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15213-3108
Mailing Address - Country:US
Mailing Address - Phone:412-683-7272
Mailing Address - Fax:412-683-0341
Practice Address - Street 1:300 HALKET ST
Practice Address - Street 2:RENAISSANCE ORTHOPAEDICS, SUITE 1601
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15213-3108
Practice Address - Country:US
Practice Address - Phone:412-683-7272
Practice Address - Fax:412-683-0341
Is Sole Proprietor?:No
Enumeration Date:2005-12-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAMA052133363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
PWQ60823Medicare UPIN