Basic Information
| Provider Information | |||||||||
| NPI: | 1649596891 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | JAHDI | ||||||||
| FirstName: | NASEEM | ||||||||
| MiddleName: | ALEXA | ||||||||
| NamePrefix: | |||||||||
| NameSuffix: | |||||||||
| Credential: | D.O. | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | |||||||||
| OtherFirstName: | |||||||||
| OtherMiddleName: | |||||||||
| OtherNamePrefix: | |||||||||
| OtherNameSuffix: | |||||||||
| OtherCredential: | |||||||||
| OtherLastNameType: | |||||||||
| Mailing Information | |||||||||
| Address1: | 1 ROBINSON PLZ STE 230 | ||||||||
| Address2: | |||||||||
| City: | PITTSBURGH | ||||||||
| State: | PA | ||||||||
| PostalCode: | 152051000 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 1273055404 | ||||||||
| FaxNumber: | 4127305542 | ||||||||
| Practice Location | |||||||||
| Address1: | 1 ROBINSON PLZ STE 230 | ||||||||
| Address2: | |||||||||
| City: | PITTSBURGH | ||||||||
| State: | PA | ||||||||
| PostalCode: | 152051000 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4127305540 | ||||||||
| FaxNumber: | 4127305542 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/13/2010 | ||||||||
| LastUpdateDate: | 03/08/2022 | ||||||||
| NPIDeactivationReasonCode: | |||||||||
| NPIDeactivationDate: | |||||||||
| NPIReactivationDate: | |||||||||
| ProviderGenderCode: | F | ||||||||
| AuthorizedOfficialLastName: | |||||||||
| AuthorizedOfficialFirstName: | |||||||||
| AuthorizedOfficialMiddleName: | |||||||||
| AuthorizedOfficialTitleorPosition: | |||||||||
| AuthorizedOfficialTelephone: | |||||||||
| IsSoleProprietor: | N | ||||||||
| IsOrganizationSubpart: | |||||||||
| ParentOrganizationLBN: | |||||||||
| AuthorizedOfficialNamePrefix: | |||||||||
| AuthorizedOfficialNameSuffix: | |||||||||
| AuthorizedOfficialCredential: | |||||||||
| NPICertificationDate: | 03/08/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RR0500X | OS017968 | PA | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Rheumatology | 207R00000X | 58003168 | OH | N | Allopathic & Osteopathic Physicians | Internal Medicine | 207R00000X | 3197 | WV | N | Allopathic & Osteopathic Physicians | Internal Medicine | 207RR0500X | 3197 | WV | N | Allopathic & Osteopathic Physicians | Internal Medicine | Rheumatology | 207RR0500X | 34.010525 | OH | N | Allopathic & Osteopathic Physicians | Internal Medicine | Rheumatology |
ID Information
| ID | Type | State | Issuer | Description | 0463194 | 05 | OH | MEDICAID | 1669562864 | 01 | OH | RICHMOND HEIGHTS MEDICAL CENTER | OTHER |