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General NPI Number Information
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NPI Number | 1265690010
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Entity Type | Organization
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Legal Business Name | UNIVERSITY OF PENNSYLVANIA
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Dates
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Enumeration Date | 05/29/2008
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Last Update Date | 05/29/2008
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Provider Practice Location Address
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Address Line | 3535 MARKET ST SUITE 670
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City | PHILADELPHIA
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State | PA
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Zip | 19104-3309
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Country | US
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Telephone | 215-746-6417
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Fax |
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Provider Business Mailing Address
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Address Line | 3535 MARKET ST SUITE 670
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City | PHILADELPHIA
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State | PA
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Zip | 19104-3309
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Country | US
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Telephone | 215-746-6417
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Fax |
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Authorized Official
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Title or Position | PROFESSOR
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Name | DR. KARL RICKELS
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Credential | M.D.
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Telephone | 215-746-6417
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 282N00000X
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Taxonomy Name | General Acute Care Hospital
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License Number | MD-026869-L
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License Number State | PA
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