Organization
TRUSTEES OF THE UNIVERSITY OF PENNSYLVANIA
Active
Parent organization
TRUSTEES OF THE UNIVERSITY OF PENNSYLVANIA
Organization subpart
Yes
Provider details
NPI number
Legal business name
TRUSTEES OF THE UNIVERSITY OF PENNSYLVANIA
Authorized official
ELIZABETH JOHNSTON (AUTHORIZED OFFICIAL)
(215) 662-7583
Entity
Organization
Contact information
Practice address
3400 SPRUCE ST, GROUND FLOOR DONNER, PHILADELPHIA, PA 19104-4206
(215) 662-6698
(215) 662-3953
Mailing address
3624 MARKET ST, SUITE 560W, PHILADELPHIA, PA 19104-2614
(215) 662-2286
Taxonomy
Speciality
Code
Description
License number
State
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
Primary
—
PA
207R00000X
Internal Medicine Physician
—
PA
Other
Enumeration date
07/10/2012
Last updated
07/10/2012
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