Provider Demographics
NPI:1134367501
Name:ANTHONY F. JAHN,M.D.,PA
Entity type:Organization
Organization Name:ANTHONY F. JAHN,M.D.,PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:FREDERICK
Authorized Official - Last Name:JAHN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:973-226-2262
Mailing Address - Street 1:556 EAGLE ROCK AVE
Mailing Address - Street 2:SUITE 201
Mailing Address - City:ROSELAND
Mailing Address - State:NJ
Mailing Address - Zip Code:07068-1503
Mailing Address - Country:US
Mailing Address - Phone:973-226-2262
Mailing Address - Fax:973-226-2664
Practice Address - Street 1:556 EAGLE ROCK AVE
Practice Address - Street 2:SUITE 201
Practice Address - City:ROSELAND
Practice Address - State:NJ
Practice Address - Zip Code:07068-1503
Practice Address - Country:US
Practice Address - Phone:973-226-2262
Practice Address - Fax:973-226-2664
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-23
Last Update Date:2009-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ43060207YX0901X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207YX0901XAllopathic & Osteopathic PhysiciansOtolaryngologyOtology & NeurotologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ425894Medicare PIN
NJB11231Medicare UPIN