Basic Information
| Provider Information | |||||||||
| NPI: | 1427495126 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | TEMPLE UNIVERSITY HOSPITAL | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3401 N BROAD ST | ||||||||
| Address2: | TEMPLE UNIVERSITY HOSPITAL | ||||||||
| City: | PHILADELPHIA | ||||||||
| State: | PA | ||||||||
| PostalCode: | 191405103 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2157072000 | ||||||||
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| Practice Location | |||||||||
| Address1: | 3401 N BROAD ST | ||||||||
| Address2: | TEMPLE UNIVERSITY HOSPITAL | ||||||||
| City: | PHILADELPHIA | ||||||||
| State: | PA | ||||||||
| PostalCode: | 191405103 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2157072000 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/04/2013 | ||||||||
| LastUpdateDate: | 06/28/2013 | ||||||||
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| ProviderGenderCode: | |||||||||
| AuthorizedOfficialLastName: | PRICE | ||||||||
| AuthorizedOfficialFirstName: | ALISON | ||||||||
| AuthorizedOfficialMiddleName: | |||||||||
| AuthorizedOfficialTitleorPosition: | SURGERY RESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 2157072000 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 282N00000X | MT204025 | PA | Y | Hospitals | General Acute Care Hospital |
No ID Information.