Organization
TRUSTEES OF THE UNIVERSITY OF PENNSYLVANIA
Active
Organization
TRUSTEES OF THE UNIVERSITY OF PENNSYLVANIA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ELIZABETH JOHNSTON (EXECUTIVE DIRECTOR)
(215) 662-7583
Entity
Organization
Contact information
Practice address
250 KING OF PRUSSIA RD, RADNOR, PA 19087-5220
(610) 902-2000
(610) 902-2040
Mailing address
3624 MARKET ST, SUITE 560W, PHILADELPHIA, PA 19104-2614
(215) 662-2286
(215) 615-0500
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
—
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0002Y21509
HEALTHNET
PA
01
—
0005754
NJ-MEDICAID
NJ
01
—
0362391000
KEYSTONE
PA
05
—
1001258770
—
PA
01
—
1038504
MERCY
PA
01
—
116472401
ACS
PA
01
—
17841
HEALTHPARTNERS
PA
01
—
273372
MAMSI
PA
01
—
300654
EEIOC
PA
01
—
635455
BLUE SHIELD
PA
01
—
709372
AETNA
PA
01
—
CN3127
RR MEDICARE
PA
01
—
G00020380
AMERICHOICE
PA
Enumeration date
08/21/2006
Last updated
05/22/2008
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up