Healthcare Provider Details

I. General information

NPI: 1881909190
Provider Name (Legal Business Name): CHILDREN'S HOSPITAL OF PHILADELPHIA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/11/2010
Last Update Date: 08/11/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

34TH STREET AND CIVIC CENTER BLVD
PHILADELPHIA PA
19104
US

IV. Provider business mailing address

2300 PINE ST APT 4A
PHILADELPHIA PA
19103-6468
US

V. Phone/Fax

Practice location:
  • Phone: 215-590-1000
  • Fax:
Mailing address:
  • Phone: 724-422-0720
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code281PC2000X
TaxonomyChildren's Chronic Disease Hospital
License NumberMA052562
License Number StatePA

VIII. Authorized Official

Name: DR. STEVEN A. ALTSCHULER
Title or Position: PRESIDENT AND CHIEF EXECUTIVE OFFIC
Credential: M.D.
Phone: 215-590-1000