# TRUSTEES OF THE UNIVERSITY OF PENNSYLVANIA

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

## Provider details

- **NPI number:** 1760552434
- **Authorized official:** ELIZABETH JOHNSTON (EXECUTIVE DIRECTOR)
- **Authorized official phone:** (215) 662-7583

## Contact information

- **Practice address:** 51 N 39TH ST, 7 FLOOR-MUTCH BUILDING, PHILADELPHIA, PA 19104-2640
- **Practice address phone:** (215) 662-8777
- **Practice address fax:** (215) 243-3290
- **Mailing address:** 3624 MARKET ST, SUITE 560W, PHILADELPHIA, PA 19104-2614
- **Mailing address phone:** (215) 662-2286
- **Mailing address fax:** (215) 615-0500

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | PA | — |
| 207QS0010X | Sports Medicine (Family Medicine) Physician | — | NULL | — |
| 207QS0010X | Sports Medicine (Family Medicine) Physician | — | — | — |
| 207V00000X | Obstetrics & Gynecology Physician | — | PA | Yes |

## Other

- **Enumeration date:** 11/09/2006
- **Last updated:** 08/08/2014