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Organization
UNIV OF PENN - INFUSION THERAPY
Active
Organization
UNIV OF PENN - INFUSION THERAPY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ELIZABETH JOHNSTON (EXECUTIVE DIRECTOR)
(215) 662-7583
Entity
Organization
Contact information
Practice address
3400 SPRUCE ST, 4 SILVERSTEIN BUILDING, PHILADELPHIA, PA 19104-4206
(215) 662-3285
(215) 662-2034
Mailing address
3624 MARKET ST, SUITE 560W, PHILADELPHIA, PA 19104-2614
(215) 662-2286
(215) 615-0500
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0015123800
—
PA
01
—
10841
HEALTHPARTNERS
PA
01
—
1831795
BLUE SHIELD
PA
01
—
2688711000
KEYSTONE
PA
01
—
2Y20647
HEALTHNET
PA
01
—
491288
AETNA
PA
01
—
7813902
MEDICAID
NJ
01
—
CI5506
RR MEDICARE
PA
Enumeration date
08/19/2006
Last updated
06/09/2008
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