# TRUSTEES OF THE UNIVERSITY OF PENNSYLVANIA

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Univ of Penn - Pathology & Lab
- **Organization subpart:** No

## Provider details

- **NPI number:** 1407965031
- **Authorized official:** ELIZABETH JOHNSTON (EXECUTIVE DIRECTOR)
- **Authorized official phone:** (215) 662-7583

## Contact information

- **Practice address:** 3400 SPRUCE ST, PHILADELPHIA, PA 19104-4206
- **Practice address phone:** (215) 662-6503
- **Mailing address:** 3624 MARKET ST, SUITE 560W, PHILADELPHIA, PA 19104-2614
- **Mailing address phone:** (215) 662-3958
- **Mailing address fax:** (866) 586-2431

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207ZC0500X | Cytopathology Physician | — | NULL | — |
| 207ZC0500X | Cytopathology Physician | — | — | — |
| 207ZN0500X | Neuropathology Physician | — | NULL | — |
| 207ZN0500X | Neuropathology Physician | — | — | — |
| 207ZP0007X | Molecular Genetic Pathology (Pathology) Physician | — | NULL | — |
| 207ZP0007X | Molecular Genetic Pathology (Pathology) Physician | — | — | — |
| 207ZP0102X | Anatomic Pathology & Clinical Pathology Physician | — | NULL | Yes |
| 207ZP0102X | Anatomic Pathology & Clinical Pathology Physician | — | — | Yes |
| 207ZP0104X | Chemical Pathology Physician | — | NULL | — |
| 207ZP0104X | Chemical Pathology Physician | — | — | — |

## Other

- **Enumeration date:** 08/29/2006
- **Last updated:** 01/24/2011