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General NPI Number Information
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NPI Number | 1598292229
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Entity Type | Organization
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Legal Business Name | THOMAS JEFFERSON UNIVERSITY HOSPITAL
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Dates
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Enumeration Date | 05/12/2017
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Last Update Date | 05/12/2017
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Provider Practice Location Address
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Address Line | 1015 CHESTNUT ST STE 1321
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City | PHILADELPHIA
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State | PA
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Zip | 19107-4313
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Country | US
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Telephone | 215-955-8354
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Fax | 215-955-2342
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Provider Business Mailing Address
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Address Line | , 1015 CHESTNUT STREET, SUITE 1321
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City | PH19107ILADELPHIA
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State | PA
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Zip | 19107
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Country | US
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Telephone | 215-955-8354
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Fax | 215-955-2342
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Authorized Official
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Title or Position | NURSE PRACTITIONER
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Name | MS. SANDRA A MOSS
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Credential | CRNP
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Telephone | 215-955-8435
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0200X
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Taxonomy Name | Pediatric Nurse Practitioner
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License Number | VP005103D
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 363LA2100X
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Taxonomy Name | Acute Care Nurse Practitioner
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License Number | SP007945
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License Number State | PA
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