Provider Demographics
NPI:1710392527
Name:DREXEL UNIVERSITY
Entity Type:Organization
Organization Name:DREXEL UNIVERSITY
Other - Org Name:DU CREATIVE ARTS THERAPY SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DEAN, DU CNHP
Authorized Official - Prefix:
Authorized Official - First Name:GLORIA
Authorized Official - Middle Name:
Authorized Official - Last Name:DONNELLY
Authorized Official - Suffix:
Authorized Official - Credentials:PHD, RN, FAAN
Authorized Official - Phone:215-762-4943
Mailing Address - Street 1:1601 CHERRY ST FL 2
Mailing Address - Street 2:PARKWAY HEALTH & WELLNESS MS 21041
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19102-1306
Mailing Address - Country:US
Mailing Address - Phone:215-553-7013
Mailing Address - Fax:215-553-7019
Practice Address - Street 1:1601 CHERRY ST FL 2
Practice Address - Street 2:MS 21041
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19102-1306
Practice Address - Country:US
Practice Address - Phone:215-553-7013
Practice Address - Fax:215-553-7019
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:DREXEL UNIVERSITY
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2014-07-01
Last Update Date:2014-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty