Provider Demographics
NPI:1821104753
Name:JEFFERSON REGIONAL MEDICAL CENTER
Entity Type:Organization
Organization Name:JEFFERSON REGIONAL MEDICAL CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL NUTRITIONIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:LEA ANN
Authorized Official - Middle Name:SWYERS
Authorized Official - Last Name:OSTERGAARD
Authorized Official - Suffix:
Authorized Official - Credentials:MS, RD, CDE, LDN
Authorized Official - Phone:412-469-7001
Mailing Address - Street 1:814 EISENHOWER DR
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15228-1702
Mailing Address - Country:US
Mailing Address - Phone:412-561-5357
Mailing Address - Fax:
Practice Address - Street 1:565 COAL VALLEY ROAD
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15236-0119
Practice Address - Country:US
Practice Address - Phone:412-469-7001
Practice Address - Fax:412-469-7725
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADN000498282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital