Organization
JEFFERSON UNIVERSITY PHYSICIANS
Active
Other names
Sleep Disorder
Organization subpart
No
Provider details
NPI number
Authorized official
HRISTOS RISTAS (VP OF CONTRACTING)
(215) 955-9298
Entity
Organization
Contact information
Practice address
833 CHESTNUT ST, SUITE 630, PHILADELPHIA, PA 19107-4414
(215) 955-0800
Mailing address
PO BOX 828937, PHILADELPHIA, PA 19182-8937
(215) 503-1240
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
113176
AETNA
PA
01
—
1153298
KEYSTONE MERCY
PA
01
—
2853760000
INDEPENDENCE BLUE CROSS
PA
01
—
383674
HIGHMARK BLUE SHIELD
PA
05
—
7904304
—
NJ
Enumeration date
04/18/2008
Last updated
10/14/2022
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