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General NPI Number Information
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NPI Number | 1861546251
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Entity Type | Individual
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Provider Name | ALEJANDRA WORTMAN M.D.
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Gender | Female
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Dates
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Enumeration Date | 01/22/2007
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Last Update Date | 01/22/2024
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Provider Practice Location Address
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Address Line | 255 S 17TH ST STE 2900
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City | PHILADELPHIA
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State | PA
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Zip | 19103-6201
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Country | US
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Telephone | 203-869-5505
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Fax | 38-695-5042
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Provider Business Mailing Address
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Address Line | 50 S 16TH ST UNIT 4310
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City | PHILADELPHIA
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State | PA
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Zip | 19102-2533
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Country | US
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Telephone | 203-869-5505
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Fax | 203-869-5504
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0804X
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Taxonomy Name | Child & Adolescent Psychiatry Physician
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License Number | 216123
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 2084P0804X
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Taxonomy Name | Child & Adolescent Psychiatry Physician
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License Number | 039844
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License Number State | CT
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Taxonomy #3
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Taxonomy Code | 2084P0804X
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Taxonomy Name | Child & Adolescent Psychiatry Physician
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License Number | 478063
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License Number State | PA
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