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General NPI Number Information
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NPI Number | 1811161052
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Entity Type | Organization
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Legal Business Name | JEFFERSON UNIVERSITY PHYSICIANS
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Dates
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Enumeration Date | 04/18/2008
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Last Update Date | 02/23/2021
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Provider Practice Location Address
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Address Line | 1100 MARKET ST FL 30
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City | PHILADELPHIA
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State | PA
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Zip | 19107-3601
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Country | US
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Telephone | 215-955-8420
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Fax |
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Provider Business Mailing Address
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Address Line | 833 CHESTNUT ST SUITE 630
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City | PHILADELPHIA
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State | PA
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Zip | 19107-4414
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Country | US
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Telephone | 215-955-0800
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Fax |
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | HRISTOS ROSTAS
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Credential |
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Telephone | 215-955-9298
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0001X
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Taxonomy Name | Clinical Cardiac Electrophysiology 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 | 207RI0011X
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Taxonomy Name | Interventional Cardiology 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 | 207RA0001X
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Taxonomy Name | Advanced Heart Failure and Transplant Cardiology 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 | 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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