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General NPI Number Information
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NPI Number | 1265744502
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Entity Type | Organization
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Legal Business Name | TEMPLE UNIV HEALTH SYSTEM
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Dates
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Enumeration Date | 07/01/2010
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Last Update Date | 01/11/2012
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Provider Practice Location Address
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Address Line | 3401 N BROAD ST C525 PARKINSON PAVILION
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City | PHILADELPHIA
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State | PA
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Zip | 19140-5103
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Country | US
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Telephone | 215-707-3040
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Fax |
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Provider Business Mailing Address
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Address Line | 3401 N BROAD ST C525 PARKINSON PAVILION
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City | PHILADELPHIA
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State | PA
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Zip | 19140-5103
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Country | US
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Telephone | 215-707-3040
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Fax |
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Authorized Official
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Title or Position | RESIDENT
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Name | PANKAJ KAKKAR
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Credential | M.D
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Telephone | 215-707-3040
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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 | MT197762
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License Number State | PA
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