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Organization
THOMAS JEFFERSON UNIVERSITY PSYCH
Active
Organization
THOMAS JEFFERSON UNIVERSITY PSYCH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOHN OGUNKEYE (EXECUTIVE DIRECTOR)
(215) 955-2562
Entity
Organization
Contact information
Practice address
833 CHESTNUT ST STE 630, PHILADELPHIA, PA 19107-4416
(215) 955-0800
Mailing address
833 CHESTNUT ST STE 630, PHILADELPHIA, PA 19107-4416
(215) 955-0800
Taxonomy
Speciality
Code
Description
License number
State
2084P0804X
Child & Adolescent Psychiatry Physician
Primary
—
NULL
2084P0804X
Child & Adolescent Psychiatry Physician
Primary
—
—
Other
Enumeration date
06/11/2008
Last updated
06/11/2008
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