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Organization
DREXEL
Active
Organization
DREXEL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JONATHAN GUERRA (INTERN)
(787) 462-2089
Entity
Organization
Contact information
Practice address
777 S BROAD ST, PHILADELPHIA, PA 19147-2504
(787) 462-2089
Mailing address
777 S BROAD ST, 210, PHILADELPHIA, PA 19147-2504
Taxonomy
Speciality
Code
Description
License number
State
282N00000X
General Acute Care Hospital
Primary
MT 197045
PA
Other
Enumeration date
07/13/2010
Last updated
07/13/2010
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