Organization
TEMPLE UNIVERSITY OF THE COMMONWEALTH SYSTEM OF HIGHER EDUCATION
Active
Other names
Temple Geriatrics
Organization subpart
No
Provider details
NPI number
Authorized official
TONYA WOODARD (CREDENTIALING MANAGER)
(215) 707-3911
Entity
Organization
Contact information
Practice address
3322 N BROAD ST, PHILADELPHIA, PA 19140-5103
(215) 707-1800
(215) 707-3644
Mailing address
2450 W HUNTING PARK AVE, PHILADELPHIA, PA 19129-1302
(215) 707-1800
(215) 707-3644
Taxonomy
Speciality
Code
Description
License number
State
207QG0300X
Geriatric Medicine (Family Medicine) Physician
Primary
—
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1007780130816
—
PA
Enumeration date
10/17/2005
Last updated
06/15/2018
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