Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

University of Penn-Medical Group

Organization Nuclear Medicine Physician · NPI 1558759571

University of Penn-Medical Group is a Nuclear Medicine Physician in Philadelphia, Pennsylvania. Licensed in Pennsylvania. Registered with an NPI since 2014.

Licensed in
PA
In the registry since
2014
Specialties on file
6

Practice location Address checks out

3400 Spruce St Ground Fl Dulles
Philadelphia, PA 19104-4238
Phone: (215) 662-3005
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Diagnostic Radiology Physician (primary) Taxonomy 2085R0202X (PA)
Nuclear Medicine Physician Taxonomy 207U00000X (PA)
Neuroradiology Physician Taxonomy 2085N0700X (PA)
Nuclear Radiology Physician Taxonomy 2085N0904X (PA)
Pediatric Radiology Physician Taxonomy 2085P0229X (PA)
Vascular & Interventional Radiology Physician Taxonomy 2085R0204X (PA)

Record details

NPI number1558759571
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Chante Jackson — Enrollment Lead · (215) 662-6187
NPI enumeratedDecember 29, 2014
Last updated in NPPESNovember 19, 2020
Certification dateNovember 19, 2020
Mailing address3400 Spruce St, Ground Floor Dulles, Philadelphia, PA 19104-4238

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