Basic Information
| Provider Information | |||||||||
| NPI: | 1770790750 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | ALBERT EINSTEIN MEDICAL CENTER | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3331 BROOKVIEW PL | ||||||||
| Address2: | |||||||||
| City: | ELKINS PARK | ||||||||
| State: | PA | ||||||||
| PostalCode: | 190272808 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8143412660 | ||||||||
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| Practice Location | |||||||||
| Address1: | 5501 OLD YORK RD | ||||||||
| Address2: | KLEIN BLDG, SUITE 510 | ||||||||
| City: | PHILADELPHIA | ||||||||
| State: | PA | ||||||||
| PostalCode: | 191413018 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2154566930 | ||||||||
| FaxNumber: | 2154563529 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/17/2007 | ||||||||
| LastUpdateDate: | 08/22/2020 | ||||||||
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| AuthorizedOfficialLastName: | BERNINI | ||||||||
| AuthorizedOfficialFirstName: | A. SUSAN | ||||||||
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| AuthorizedOfficialTitleorPosition: | COO | ||||||||
| AuthorizedOfficialTelephone: | 2154567890 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 390200000X | MD430344 | PA | Y | 193400000X SINGLE SPECIALTY GROUP | Student, Health Care | Student in an Organized Health Care Education/Training Program |
No ID Information.