Organization
THOMAS JEFFERSON UNIVERSITY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SARA M SHANE PSY.D. (EXECUTIVE DIRECTOR)
(215) 890-6289
Entity
Organization
Contact information
Practice address
833 CHESTNUT ST, SUITE 210-E, PHILADELPHIA, PA 19107-4414
(215) 955-2542
(215) 503-2850
Mailing address
833 CHESTNUT ST STE 210E, PHILADELPHIA, PA 19107-4405
(215) 890-6277
(215) 790-9947
Taxonomy
Speciality
Code
Description
License number
State
251K00000X
Public Health or Welfare Agency
Primary
820023
PA
Other
Enumeration date
02/15/2007
Last updated
01/07/2026
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