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General NPI Number Information
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NPI Number | 1659657872
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Entity Type | Organization
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Legal Business Name | HAHNEMANN UNIVERSITY HOSPITAL
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Dates
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Enumeration Date | 11/02/2011
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Last Update Date | 11/02/2011
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Provider Practice Location Address
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Address Line | 245 N. 15TH STREET, MS #435 DEPARTMENT OF PATHOLOGY
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City | PHILADELPHIA
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State | PA
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Zip | 19102
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Country | US
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Telephone | 215-762-1673
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Fax |
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Provider Business Mailing Address
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Address Line | 245 N. 15TH STREET, MS #435 DEPARTMENT OF PATHOLOGY,
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City | PHILADELPHIA
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State | PA
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Zip | 19102
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Country | US
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Telephone | 215-762-1673
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Fax |
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Authorized Official
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Title or Position | PGY1 PATHOLOGY
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Name | DR. MICHAEL PROCHASKA
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Credential | M.D.
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Telephone | 215-762-1673
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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 | MT200468
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License Number State | PA
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