Provider Demographics
NPI:1972760189
Name:THOMAS JEFFERSON UNIVERSITY HOSPITAL
Entity Type:Organization
Organization Name:THOMAS JEFFERSON UNIVERSITY HOSPITAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:RESIDENT PGY 3
Authorized Official - Prefix:MR
Authorized Official - First Name:ALESSANDRO
Authorized Official - Middle Name:
Authorized Official - Last Name:BOMBONATI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:215-955-6352
Mailing Address - Street 1:132 S 10TH ST
Mailing Address - Street 2:285 MAIN BLDG
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19107-5244
Mailing Address - Country:US
Mailing Address - Phone:215-955-6352
Mailing Address - Fax:
Practice Address - Street 1:132 S 10TH ST
Practice Address - Street 2:285 MAIN BLDG
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19107-5244
Practice Address - Country:US
Practice Address - Phone:215-955-6352
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-16
Last Update Date:2008-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMT185329282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital