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General NPI Number Information
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NPI Number | 1629403753
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Entity Type | Organization
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Legal Business Name | THE CHILDREN HOSPITAL OF PHILADELPHIA
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Dates
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Enumeration Date | 09/09/2013
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Last Update Date | 06/28/2016
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Provider Practice Location Address
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Address Line | 3401 CIVIC CENTER BLVD
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City | PHILADELPHIA
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State | PA
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Zip | 19104-4319
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Country | US
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Telephone | 609-553-0902
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Fax |
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Provider Business Mailing Address
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Address Line | 3401 CIVIC CENTER BLVD
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City | PHILADELPHIA
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State | PA
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Zip | 19104-4319
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Country | US
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Telephone | 609-553-0902
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Fax |
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Authorized Official
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Title or Position | RESIDENT
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Name | DR. ANDREA JUDIT MACHNITZ
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Credential | M.D.
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Telephone | 609-553-9021
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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 | MT202078
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 282N00000X
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Taxonomy Name | General Acute Care Hospital
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License Number | 25MA09896400
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License Number State | NJ
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