University of Penn-Medical Group
University of Penn-Medical Group is an Optometrist in Philadelphia, Pennsylvania. Licensed in Pennsylvania. Registered with an NPI since 2014.
- Licensed in
- PA
- In the registry since
- 2014
- Specialties on file
- 2
Practice location Address checks out
3400 Civic Center Blvd West Pavilion 3rd Fl Ste 3-144WPhiladelphia, PA 19104-5127
Phone: (215) 614-4100
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Ophthalmology Physician (primary) | Taxonomy 207W00000X (PA) |
|---|---|
| Optometrist | Taxonomy 152W00000X (PA) |
Record details
| NPI number | 1316335425 |
|---|---|
| Entity type | Organization (Type 2) |
| Organization subpart | No |
| Authorized official | Chante Jackson — Enrollment Lead · (215) 662-6187 |
| NPI enumerated | December 26, 2014 |
| Last updated in NPPES | November 19, 2020 |
| Certification date | November 19, 2020 |
| Mailing address | 3400 Civic Center Blvd, West Pavilion, 3rd Floor Suite 3-144w, Philadelphia, PA 19104-5127 |
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