Organization
UNIVERSITY OF PENN-NEUROLOGY ASSTS.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ELIZABETH JOHNSTON (EXECUTIVE DIRECTOR)
(215) 662-7583
Entity
Organization
Contact information
Practice address
3400 SPRUCE ST, 2 RAVDIN, PHILADELPHIA, PA 19104-4206
(215) 662-3606
Mailing address
3400 SPRUCE ST, 2 RAVDIN, PHILADELPHIA, PA 19104-4206
(215) 662-3606
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
—
PA
2084N0402X
Neurology with Special Qualifications in Child Neurology Physician
—
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0002Y21675
HEALTHNET
PA
01
—
005023
AETNA
PA
01
—
0055785000
KEYSTONE
PA
01
—
039188
BLUE SHIELD
PA
05
—
1001258770
—
PA
01
—
1008658
MERCY
PA
01
—
10375
HEALTHPARTNERS
PA
01
—
118289600
ACS
PA
01
—
203677
EEIOC
PA
01
—
273304
MAMSI
PA
05
—
3578909
—
NJ
01
—
CA1585
RR MEDICARE
PA
01
—
G00031400
AMERICHOICE
PA
Enumeration date
08/30/2006
Last updated
01/06/2014
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