Organization
STC OPCO LLC
Active
Other names
St Christophers Hospital for Children Immunology
Organization subpart
No
Provider details
NPI number
Authorized official
GARY CONNER (VP & CFO)
(484) 628-8181
Entity
Organization
Contact information
Practice address
160 E ERIE AVE, PHILADELPHIA, PA 19134-1011
(215) 427-5000
Mailing address
PO BOX 13579, READING, PA 19612-3579
Taxonomy
Speciality
Code
Description
License number
State
207K00000X
Allergy & Immunology Physician
—
—
207RA0201X
Allergy & Immunology (Internal Medicine) Physician
—
—
2080I0007X
Pediatric Clinical & Laboratory Immunology Physician
Primary
—
—
Other
Enumeration date
11/27/2019
Last updated
01/02/2020
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