Organization
TRUSTEES OF THE UNIV OF PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ELIZABETH JOHNSTON (EXECUTIVE DIRECTOR)
(215) 662-7583
Entity
Organization
Contact information
Practice address
250 KING OF PRUSSIA RD, RADNOR, PA 19087-5220
(610) 902-2000
(610) 902-2040
Mailing address
3624 MARKET ST, SUITE 560W, PHILADELPHIA, PA 19104-2614
(215) 662-2286
(215) 615-0500
Taxonomy
Speciality
Code
Description
License number
State
207ZB0001X
Blood Banking & Transfusion Medicine Physician
—
PA
207ZC0500X
Cytopathology Physician
—
PA
207ZD0900X
Dermatopathology (Pathology) Physician
—
PA
207ZF0201X
Forensic Pathology Physician
—
PA
207ZI0100X
Immunopathology Physician
—
PA
207ZM0300X
Medical Microbiology Physician
—
PA
207ZP0007X
Molecular Genetic Pathology (Pathology) Physician
—
PA
207ZP0101X
Anatomic Pathology Physician
Primary
—
PA
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
—
PA
207ZP0104X
Chemical Pathology Physician
—
PA
207ZP0105X
Clinical Pathology/Laboratory Medicine Physician
—
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0170486000
KEYSTONE
PA
05
—
1001258770
—
PA
01
—
1038539
MERCY
PA
01
—
184052
BLUE SHIELD
PA
01
—
25325
HEALTHPARTNERS
PA
01
—
273379
MAMSI
PA
01
—
300654
EEIOC
PA
01
—
710842
AETNA
PA
01
—
7537000
NJ-MEDICAID
NJ
01
—
CN3127
RR MEDICARE
PA
01
—
E98600
AMERICHOICE
PA
Enumeration date
08/21/2006
Last updated
09/11/2025
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up