Provider Demographics
NPI:1659657872
Name:HAHNEMANN UNIVERSITY HOSPITAL
Entity Type:Organization
Organization Name:HAHNEMANN UNIVERSITY HOSPITAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PGY1 PATHOLOGY
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:PROCHASKA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:215-762-1673
Mailing Address - Street 1:245 N. 15TH STREET, MS #435
Mailing Address - Street 2:DEPARTMENT OF PATHOLOGY,
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19102
Mailing Address - Country:US
Mailing Address - Phone:215-762-1673
Mailing Address - Fax:
Practice Address - Street 1:245 N. 15TH STREET, MS #435
Practice Address - Street 2:DEPARTMENT OF PATHOLOGY
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19102
Practice Address - Country:US
Practice Address - Phone:215-762-1673
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-11-02
Last Update Date:2011-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMT200468282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital