Provider Demographics
NPI:1821345893
Name:CORBO, JASON MICHAEL (PHARMD, BCPS)
Entity Type:Individual
Prefix:
First Name:JASON
Middle Name:MICHAEL
Last Name:CORBO
Suffix:
Gender:M
Credentials:PHARMD, BCPS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:815 FREEPORT RD
Mailing Address - Street 2:DEPARTMENT OF MEDICAL EDUCATION
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15215-3301
Mailing Address - Country:US
Mailing Address - Phone:412-784-5320
Mailing Address - Fax:
Practice Address - Street 1:815 FREEPORT RD
Practice Address - Street 2:DEPARTMENT OF MEDICAL EDUCATION
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15215-3301
Practice Address - Country:US
Practice Address - Phone:412-784-5320
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-08-09
Last Update Date:2015-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CTPCT.00116561835G0303X, 1835P1200X, 1835P0018X
PARP4472291835G0303X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835G0303XPharmacy Service ProvidersPharmacistGeriatric
No1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy
No1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist