# UNIV OF PENN IMAGING CENTER

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1205945367
- **Authorized official:** ELIZABETH JOHNSTON (EXECUTIVE DIRECTOR)
- **Authorized official phone:** (215) 615-7583

## Contact information

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

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 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 | — | NULL | Yes |
| 2085R0204X | Vascular & Interventional Radiology Physician | — | — | Yes |

## Other

- **Enumeration date:** 08/30/2006
- **Last updated:** 09/11/2025