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Organization
UNIV OF PENN - RADIOLOGY
Active
Organization
UNIV OF PENN - RADIOLOGY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ELIZABETH JOHNSTON (EXECUTIVE DIRECTOR)
(215) 662-3005
Entity
Organization
Contact information
Practice address
3400 SPRUCE ST, GROUND FLOOR DULLES, PHILADELPHIA, PA 19104-4206
(215) 662-3005
(215) 662-7011
Mailing address
3624 MARKET ST, SUITE 560W, PHILADELPHIA, PA 19104-2614
(215) 662-2286
(215) 615-0500
Taxonomy
Speciality
Code
Description
License number
State
2085N0700X
Neuroradiology Physician
—
NULL
2085N0700X
Neuroradiology Physician
—
—
2085N0904X
Nuclear Radiology Physician
—
NULL
2085N0904X
Nuclear Radiology Physician
—
—
2085R0202X
Diagnostic Radiology Physician
—
NULL
2085R0202X
Diagnostic Radiology Physician
—
—
2085R0204X
Vascular & Interventional Radiology Physician
Primary
—
NULL
2085R0204X
Vascular & Interventional Radiology Physician
Primary
—
—
Other
Enumeration date
08/14/2006
Last updated
09/11/2025
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