Organization
JEFFERSON UNIVERSITY PHYSICIANS
Active
Organization
JEFFERSON UNIVERSITY PHYSICIANS
Active
Other names
Jefferson Center for Dermatopathology
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOHN OGUNKEYE (EXECUTIVE DIRECTOR)
(215) 955-2562
Entity
Organization
Contact information
Practice address
833 CHESTNUT ST, SUITE 630, JUP CENTRAL ENOLLMENTS, PHILADELPHIA, PA 19107-4414
(215) 955-0800
Mailing address
833 CHESTNUT ST, SUITE 630, JUP CENTRAL ENOLLMENTS, PHILADELPHIA, PA 19107-4414
(215) 955-0800
Taxonomy
Speciality
Code
Description
License number
State
207ND0900X
Dermatopathology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
6891517
AETNA
PA
Enumeration date
07/31/2009
Last updated
07/31/2009
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