Organization
JEFFERSON UNIVERSITY PHYSICIANS
Active
Other names
Neurology- General
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 SUITE 630, PHILADELPHIA, PA 19182-8937
(215) 503-1240
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0444973000
INDEPENDENCE BLUE CROSS
PA
01
—
48506
KEYSTONE MERCY
PA
05
—
7696507
—
NJ
01
—
955345
AETNA
PA
01
—
959656
HIGHMARK BLUE SHIELD
PA
Enumeration date
04/18/2008
Last updated
10/14/2022
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