Organization
DREXEL UNIVERSITY
Active
Other names
Drexel Nutritional Counseling
Organization subpart
No
Provider details
NPI number
Authorized official
EILEEN MASTERSON-CARR (EXECUTIVE DIRECTOR OF REVENUE CYCLE)
(215) 255-7766
Entity
Organization
Contact information
Practice address
219 N. BROAD ST., 9TH FLOOR, PHILADELPHIA, PA 19107
(215) 762-2688
(215) 762-2689
Mailing address
1601 CHERRY ST, SUITE 11511, PHILADELPHIA, PA 19102
(215) 255-7822
(215) 255-7825
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3501980000
IBC (KEYSTONE HEALTH PLAN EAST/PERSONAL CHOICE) GROUP NUMBER
PA
Enumeration date
05/19/2008
Last updated
09/14/2016
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