Provider Demographics
NPI:1205272804
Name:JEFFERSON UNIVERSITY HOSPITAL
Entity type:Organization
Organization Name:JEFFERSON UNIVERSITY HOSPITAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:RESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ANGELA
Authorized Official - Middle Name:
Authorized Official - Last Name:CRUDELE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:215-955-8768
Mailing Address - Street 1:1025 WALNUT ST
Mailing Address - Street 2:SUITE 801
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19107-5001
Mailing Address - Country:US
Mailing Address - Phone:215-955-8768
Mailing Address - Fax:215-955-3890
Practice Address - Street 1:1025 WALNUT ST
Practice Address - Street 2:SUITE 801
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19107-5001
Practice Address - Country:US
Practice Address - Phone:215-955-8768
Practice Address - Fax:215-955-3890
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-22
Last Update Date:2013-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital