Organization
JEFFERSON HEADACHE CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. PATRICE S GUILD DIRECTOR, OPERATIONS (DIRECTOR OF OPERATIONS)
(215) 955-2212
Entity
Organization
Contact information
Practice address
111 S 11TH ST, SUITE 8130 GIBBON BUILDING, PHILADELPHIA, PA 19107-4824
(215) 955-2727
(215) 955-6682
Mailing address
111 S 11TH ST, SUITE 8130 GIBBON BUILDING, PHILADELPHIA, PA 19107-4824
(215) 955-2727
(215) 955-6682
Taxonomy
Speciality
Code
Description
License number
State
282N00000X
General Acute Care Hospital
Primary
438132
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
438132
MEDICAL LICENCE NUMBER
PA
Enumeration date
09/21/2009
Last updated
09/21/2009
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