Organization
UNIVERSITY OF PENN - MEDICAL GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STACY GRECO (PAYER ENROLLMENT MANAGER)
(223) 341-8516
Entity
Organization
Contact information
Practice address
3400 SPRUCE ST, PHILADELPHIA, PA 19104-4206
(215) 662-4000
Mailing address
3600 CIVIC CENTER BLVD # 300E, PHILADELPHIA, PA 19104-4310
(215) 662-2286
(215) 615-0500
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
—
—
208M00000X
Hospitalist Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0002Y20116
HEALTHNET
PA
05
—
0006610360
—
PA
01
—
003473
AETNA
PA
01
—
0053945000
KEYSTONE
PA
01
—
06638
HEALTHPARTNERS
PA
01
—
147249
BLUE SHIELD
PA
01
—
40063
KEYSTONE MERCY
PA
05
—
5543509
—
NJ
01
—
CA0235
RAILROAD
PA
Enumeration date
02/26/2007
Last updated
10/14/2025
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