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General NPI Number Information
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NPI Number | 1285580472
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Entity Type | Organization
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Legal Business Name | UNIVERSITY OF PENN - MEDICAL GROUP
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Dates
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Enumeration Date | 03/09/2026
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Last Update Date | 03/09/2026
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Provider Practice Location Address
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Address Line | 501 S 54TH ST
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City | PHILADELPHIA
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State | PA
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Zip | 19143-1900
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Country | US
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Telephone | 800-789-7366
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Fax |
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Provider Business Mailing Address
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Address Line | 501 S 54TH ST
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City | PHILADELPHIA
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State | PA
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Zip | 19143-1900
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Country | US
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Telephone | 800-789-7366
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Fax |
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Authorized Official
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Title or Position | SENIOR ENROLLMENT MANAGER
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Name | STACY GRECO
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Credential |
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Telephone | 223-341-8516
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 207RI0200X
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Taxonomy Name | Infectious Disease Physician
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 207RN0300X
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Taxonomy Name | Nephrology Physician
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 207RP1001X
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Taxonomy Name | Pulmonary Disease Physician
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State |
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Taxonomy #7
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Taxonomy Code | 2086S0127X
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Taxonomy Name | Trauma Surgery Physician
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License Number |
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License Number State |
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Taxonomy #8
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Taxonomy Code | 2086S0129X
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Taxonomy Name | Vascular Surgery Physician
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License Number |
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License Number State |
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Taxonomy #9
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Taxonomy Code | 208800000X
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Taxonomy Name | Urology Physician
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License Number |
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License Number State |
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Taxonomy #10
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number |
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License Number State |
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