Basic Information
| Provider Information | |||||||||
| NPI: | 1548586860 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | JEFFERSON HOSPITAL | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1020 SPRUCE ST APT 3F | ||||||||
| Address2: | |||||||||
| City: | PHILADELPHIA | ||||||||
| State: | PA | ||||||||
| PostalCode: | 191076074 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6073290263 | ||||||||
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| Practice Location | |||||||||
| Address1: | 111 S 11TH ST | ||||||||
| Address2: | |||||||||
| City: | PHILADELPHIA | ||||||||
| State: | PA | ||||||||
| PostalCode: | 191074824 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2159556000 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 04/12/2010 | ||||||||
| LastUpdateDate: | 04/12/2010 | ||||||||
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| AuthorizedOfficialLastName: | REGAN | ||||||||
| AuthorizedOfficialFirstName: | KATELYN | ||||||||
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| AuthorizedOfficialTitleorPosition: | OFFICE OF HOUSE STAFF AFFAIRS | ||||||||
| AuthorizedOfficialTelephone: | 2155034053 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 282N00000X | Y | Hospitals | General Acute Care Hospital |
No ID Information.