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

Organization Urology Physician · NPI 1801284823

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

Licensed in
PA
In the registry since
2014
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Practice location Address checks out

3400 Civic Center Blvd West Pavilion 3rd Fl
Philadelphia, PA 19104-5127
Phone: (215) 662-2891
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Urology Physician (primary) Taxonomy 208800000X (PA)

Record details

NPI number1801284823
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Chante Jackson — Enrollment Lead · (215) 662-6187
NPI enumeratedDecember 29, 2014
Last updated in NPPESNovember 20, 2020
Certification dateNovember 20, 2020
Mailing address3400 Civic Center Blvd, West Pavilion, 3rd Floor, Philadelphia, PA 19104-5127

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