Thomas Jefferson University | |
1021 South 21st Street Philadelphia PA 19146 | |
(215) 735-5979 | |
Not Available |
Full Name | Thomas Jefferson University |
---|---|
Speciality | Public Health Or Welfare |
Location | 1021 South 21st Street, Philadelphia, Pennsylvania |
Authorized Official Name and Position | Robert Charles Sterling (DIRECTOR) |
Authorized Official Contact | 2157909942 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Thomas Jefferson University 1021 S 21st St Philadelphia PA 19146-2634 Ph: (215) 790-9942 | Thomas Jefferson University 1021 South 21st Street Philadelphia PA 19146 Ph: (215) 735-5979 |
NPI Number | 1467547968 |
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Provider Enumeration Date | 10/03/2006 |
Last Update Date | 01/31/2020 |
Certification Date | 01/31/2020 |
Identifier | Type | State | Issuer |
---|---|---|---|
1467547968 | NPI | - | NPPES |
1007571300083 | Other | PA | MEDICAID |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
103TA0400X | Psychologist - Addiction (substance Use Disorder) | (* (Not Available)) | Secondary |
251K00000X | Public Health Or Welfare | 820023 (Pennsylvania) | Primary |
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