Organization
TRUSTEES OF THE UNIVERSITY OF PENNSYLVANIA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ELIZABETH JOHNSTON (EXECUTIVE DIRECTOR)
(215) 662-7583
Entity
Organization
Contact information
Practice address
3400 SPRUCE ST, 4TH FLOOR SILVERSTEIN, PHILADELPHIA, PA 19104-4206
(215) 615-4949
Mailing address
3624 MARKET ST, SUITE 560W, PHILADELPHIA, PA 19104-2614
(215) 662-2286
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
—
PA
2086S0129X
Vascular Surgery Physician
—
PA
363LA2200X
Adult Health Nurse Practitioner
—
PA
Other
Enumeration date
03/19/2007
Last updated
01/06/2014
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