Provider Demographics
NPI:1699051920
Name:CHILDREN'S HOSPITAL OF PITTSBURGH OF UPMC
Entity type:Organization
Organization Name:CHILDREN'S HOSPITAL OF PITTSBURGH OF UPMC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN ASSISTANT LEVEL 1
Authorized Official - Prefix:MRS
Authorized Official - First Name:JONELLE
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:CHIR
Authorized Official - Suffix:
Authorized Official - Credentials:PA-C
Authorized Official - Phone:412-999-3074
Mailing Address - Street 1:2315 VONDERA ST
Mailing Address - Street 2:
Mailing Address - City:MUNHALL
Mailing Address - State:PA
Mailing Address - Zip Code:15120-2650
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1 CHILDRENS HOSPITAL DR
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15224-1529
Practice Address - Country:US
Practice Address - Phone:412-692-5460
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-11-01
Last Update Date:2011-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMA054991282NC2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282NC2000XHospitalsGeneral Acute Care HospitalChildren