Provider Demographics
NPI:1457778615
Name:UNIVERSITY EAR, NOSE & THROAT SPECIALISTS
Entity Type:Organization
Organization Name:UNIVERSITY EAR, NOSE & THROAT SPECIALISTS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHAIRMAN, DEPT OF OTOLARYNGOLOGY
Authorized Official - Prefix:DR
Authorized Official - First Name:JONAS
Authorized Official - Middle Name:T
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:412-647-2130
Mailing Address - Street 1:1400 LOCUST ST
Mailing Address - Street 2:BLDG B SUITE 11500
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15219-5114
Mailing Address - Country:US
Mailing Address - Phone:412-232-8970
Mailing Address - Fax:412-232-8525
Practice Address - Street 1:1400 LOCUST ST
Practice Address - Street 2:BLDG D SUITE 2100
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15219-5114
Practice Address - Country:US
Practice Address - Phone:412-232-7464
Practice Address - Fax:412-232-8988
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-03-26
Last Update Date:2014-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASL008447261QH0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0700XAmbulatory Health Care FacilitiesClinic/CenterHearing and Speech