Provider Demographics
NPI:1740326925
Name:UPMC JAMESON
Entity type:Organization
Organization Name:UPMC JAMESON
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:ROBERT
Authorized Official - Last Name:AUBEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:724-656-4008
Mailing Address - Street 1:1211 WILMINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:NEW CASTLE
Mailing Address - State:PA
Mailing Address - Zip Code:16105-2516
Mailing Address - Country:US
Mailing Address - Phone:724-658-9001
Mailing Address - Fax:724-656-4230
Practice Address - Street 1:1211 WILMINGTON AVE
Practice Address - Street 2:
Practice Address - City:NEW CASTLE
Practice Address - State:PA
Practice Address - Zip Code:16105-2516
Practice Address - Country:US
Practice Address - Phone:724-658-9001
Practice Address - Fax:724-656-4230
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:UPMC JAMESON
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-01-29
Last Update Date:2016-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAAT006085231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1000021890024Medicaid
PA1000021890024Medicaid