Provider Demographics
NPI:1265690010
Name:UNIVERSITY OF PENNSYLVANIA
Entity Type:Organization
Organization Name:UNIVERSITY OF PENNSYLVANIA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROFESSOR
Authorized Official - Prefix:DR
Authorized Official - First Name:KARL
Authorized Official - Middle Name:
Authorized Official - Last Name:RICKELS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:215-746-6417
Mailing Address - Street 1:3535 MARKET ST
Mailing Address - Street 2:SUITE 670
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19104-3309
Mailing Address - Country:US
Mailing Address - Phone:215-746-6417
Mailing Address - Fax:
Practice Address - Street 1:3535 MARKET ST
Practice Address - Street 2:SUITE 670
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19104-3309
Practice Address - Country:US
Practice Address - Phone:215-746-6417
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-29
Last Update Date:2008-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD-026869-L282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital