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Organization

THOMAS JEFFERSON UNIVERSITY

Active
Organization subpart
No

Provider details

NPI number
Authorized official
SUSAN BEAL (DIRECTOR)
(215) 503-1295
Entity
Organization

Contact information

Practice address
111 S 11TH ST, SUITE 4240, PHILADELPHIA, PA 19107-4824
(215) 955-8874
Mailing address
125 S 9TH ST, SUITE 801, PHILADELPHIA, PA 19107-5125
(215) 955-9642

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MD053709L
PA

Other

Enumeration date
11/29/2006
Last updated
08/22/2020
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