Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 204E00000X | Oral & Maxillofacial Surgeon | DS017537L | PA |
NPI | 1407838626 |
---|---|
Provider Name | Jay M Schulhof |
First Address | Pittsburgh, PA 15228-1626 |
Second Address | Pittsburgh, PA 15228-1626 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 15/11/2005 |
Last Update Date | 26/03/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0794355 | (05) | PA |
T72159 | (02) |