Organization
THOMAS JEFFERSON UNIVERSITY
Active
Other names
Jefferson Univ - MATER Family Center
Organization subpart
No
Provider details
NPI number
Authorized official
MICHELLE CALVANO BA (BUSINESS MANAGER)
(215) 955-1952
Entity
Organization
Contact information
Practice address
1233 LOCUST ST, SUITE 201, PHILADELPHIA, PA 19107-5453
(215) 955-1952
(215) 568-6414
Mailing address
1233 LOCUST ST, SUITE 201, PHILADELPHIA, PA 19107-5453
(215) 955-1952
(215) 568-6414
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
N8LT6601
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1007571300104
—
PA
Enumeration date
11/20/2008
Last updated
06/14/2012
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