Organization
UNIV OF PENN - OB-GYN
Active
Organization
UNIV OF PENN - OB-GYN
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ELIZABETH JOHNSTON (EXECUTIVE DIRECTOR)
(215) 662-7583
Entity
Organization
Contact information
Practice address
3701 MARKET ST, 7TH AND 8TH FLOOR, PHILADELPHIA, PA 19104-5502
(215) 662-6100
Mailing address
3624 MARKET ST, SUITE 560W, PHILADELPHIA, PA 19104-2614
(215) 662-2286
(215) 615-0500
Taxonomy
Speciality
Code
Description
License number
State
207VE0102X
Reproductive Endocrinology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0052759000
KEYSTONE
PA
01
—
039030
BLUE SHIELD
PA
05
—
1007448840
—
PA
01
—
1012028
MERCY
PA
01
—
24199
HEALTHPARTNERS
PA
01
—
273253
MAMSI
PA
01
—
2Y20350
HEALTHNET
PA
01
—
490613
AETNA
PA
05
—
7298609
—
NJ
Enumeration date
02/26/2007
Last updated
08/22/2020
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