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	251K00000X	Public Health or Welfare Agency

General Provider Information

NPI Number	:	1386779957
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DREXEL UNIVERSITY

Provider Business Mailing Address
First Line	:	1601 CHERRY ST STE 11511
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19102-1310
Country	:	US
Telephone Number	:	215-255-7751
Fax Number	:	215-255-7825

Provider Business Practice Location Address
First Line	:	4700 WISSAHICKON AVE
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19144-4248
Country	:	US
Telephone Number	:	215-831-4811
Fax Number	:	215-831-2603

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

Provider Enumeration Date	:	02/22/2007
Last Update Date	:	06/09/2022

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Directions to “DREXEL UNIVERSITY ” Practice Location

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