Healthcare Provider Details

I. General information

NPI: 1659665891
Provider Name (Legal Business Name): MELANIE RUFFNER MD, PHD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/06/2011
Last Update Date: 03/10/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3550 MARKET ST FL 3 CHOP- DIVISION OF ALLERGY AND IMMUNOLOGY
PHILADELPHIA PA
19104-3365
US

IV. Provider business mailing address

3550 MARKET ST FL 3 CHOP- DIVISION OF ALLERGY AND IMMUNOLOGY
PHILADELPHIA PA
19104-3365
US

V. Phone/Fax

Practice location:
  • Phone: 215-590-2549
  • Fax: 215-590-6849
Mailing address:
  • Phone: 215-590-2549
  • Fax: 215-590-6849

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberMT199539
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code2080P0201X
TaxonomyPediatric Allergy/Immunology Physician
License NumberMD450985
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: