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1336160027

NPI Code Detail

MEDICARE: DREXEL UNIVERSITY

MEDICARE: DREXEL UNIVERSITY

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207W00000X	Ophthalmology Physician
2	152W00000X	Optometrist

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	01628	OTHER	PA	HEALTH PARTNERS PA
2	0053189000	OTHER	PA	KEYSTONE EAST OPHTHALMOLO
3	2248	OTHER	PA	AETNA US HEALTHCARE
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	0062163000	OTHER	PA	KEYSTONE EAST OPTOMETRIC
6	026958	OTHER	PA	PA BLUE SHIELD OPTOMETRIC
7	1002136	OTHER	PA	MERCY HEALTH PLAN PA
8	132200	OTHER	PA	PA BLUE SHIELD OPHTHALMOL

General Provider Information

NPI Number	:	1336160027
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DREXEL UNIVERSITY

Provider Business Mailing Address
First Line	:	1200 W GODFREY AVE
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19141-3323
Country	:	US
Telephone Number	:	215-276-6000
Fax Number	:	215-276-1329

Provider Business Practice Location Address
First Line	:	1200 W GODFREY AVE
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19141-3323
Country	:	US
Telephone Number	:	215-276-6000
Fax Number	:	215-276-1329

Authorized Official
Title or Position	:	DIRECTOR OF REVENUE CYCLE
Name	:	MR. EDWARD E WALDOV
Credential	:
Telephone Number	:	215-255-7751

Provider Enumeration Date	:	07/21/2006
Last Update Date	:	04/04/2025

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1962494096 — RISA M. MANDELL MSW
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1427033406 — DR. SHITAL V MANI
Practice Location Address:

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19141-3323

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1134166572 — PENNSYLVANIA COLLEGE OF OPTOMETRY
Practice Location Address:

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1710912167 — DR. DAVID MELTZER O.D.
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Directions to “DREXEL UNIVERSITY ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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