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General NPI Number Information
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NPI Number | 1982915856
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Entity Type | Organization
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Legal Business Name | ST. CHRISTOPHER'S HOSPITAL
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Dates
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Enumeration Date | 06/25/2010
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Last Update Date | 06/25/2010
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Provider Practice Location Address
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Address Line | 136 N BREAD ST APT 224
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City | PHILADELPHIA
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State | PA
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Zip | 19106-1943
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Country | US
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Telephone | 215-378-2033
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Fax |
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Provider Business Mailing Address
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Address Line | 136 N BREAD ST APT 224
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City | PHILADELPHIA
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State | PA
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Zip | 19106-1943
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PEDIATRIC RESIDENT
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Name | CHRISTINA MARIE OTT
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Credential | M.D.
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Telephone | 215-378-2033
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 282NC2000X
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Taxonomy Name | Children's Hospital
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License Number | MT198317
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License Number State | PA
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