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Organization

UNIV OF PENN IMAGING CENTER

Active
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Organization

UNIV OF PENN IMAGING CENTER

Active
Organization subpart
No

Provider details

NPI number
Authorized official
ELIZABETH JOHNSTON (EXECUTIVE DIRECTOR)
(215) 615-7583
Entity
Organization

Contact information

Practice address
3400 SPRUCE ST, PHILADELPHIA, PA 19104-4206
(215) 614-1926
Mailing address
3624 MARKET ST, SUITE 560W, PHILADELPHIA, PA 19104-2614
(215) 662-2286

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
08/30/2006
Last updated
09/11/2025
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