Organization
JEFFERSON UNIVERSITY PHYSICIANS
Active
Other names
Physical Medicine & Rehab
Organization subpart
No
Provider details
NPI number
Authorized official
DAWN PADGETT (CREDENTIALING MANAGER)
(215) 955-1175
Entity
Organization
Contact information
Practice address
33 S 9TH ST STE 301, PHILADELPHIA, PA 19107-4408
(215) 955-7190
Mailing address
PO BOX 828937, PHILADELPHIA, PA 19182-8937
(215) 503-1240
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0445126000
INDEPENDENCE BLUE CROSS
PA
01
—
45245
KEYSTONE MERCY
PA
05
—
7520701
—
NJ
01
—
959676
HIGHMARK BLUE SHIELD
PA
01
—
972126
AETNA
PA
Enumeration date
04/18/2008
Last updated
06/13/2024
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