Organization
JEFFERSON UNIVERSITY PHYSICIANS
Active
Other names
JEFFERSON WOMEN'S PRIMARY CARE
Organization subpart
No
Provider details
NPI number
Authorized official
MR. HRISTOS RISTAS (VP OF CONTRACTING)
(215) 955-9298
Entity
Organization
Contact information
Practice address
834 WALNUT ST, SUITE 110, PHILADELPHIA, PA 19107-5109
(215) 503-4779
Mailing address
PO BOX 828937, PHILADELPHIA, PA 19182-8937
(215) 503-1240
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1007729870101
—
PA
Enumeration date
02/05/2014
Last updated
10/14/2022
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