Organization
TEMPLE UNIVERSITY OF THE COMMONWEALTH SYSTEM OF HIGHER EDUCATION
Active
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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