Organization
UPENN LIFE
Active
Parent organization
UPENN SCHOOL OF NURSING
Organization subpart
Yes
Provider details
NPI number
Legal business name
UPENN SCHOOL OF NURSING
Authorized official
DR. BRUCE KINOSIAN MD (MEDICAL DIRECTOR)
(215) 573-7200
Entity
Organization
Contact information
Practice address
4508 CHESTNUT ST, PHILADELPHIA, PA 19139-3608
(215) 573-7200
Mailing address
4508 CHESTNUT ST, PHILADELPHIA, PA 19139-3608
(215) 573-7200
Taxonomy
Speciality
Code
Description
License number
State
302R00000X
Health Maintenance Organization
Primary
MD421701
PA
Other
Enumeration date
07/22/2008
Last updated
07/22/2008
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