Provider Demographics
NPI:1295424174
Name:DREXEL UNIVERSITY
Entity type:Organization
Organization Name:DREXEL UNIVERSITY
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF REVENUE CYCLE
Authorized Official - Prefix:
Authorized Official - First Name:EDWARD
Authorized Official - Middle Name:E
Authorized Official - Last Name:WALDOV
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:215-255-7751
Mailing Address - Street 1:245 N 15TH ST STE 6104
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19102-1198
Mailing Address - Country:US
Mailing Address - Phone:267-359-2518
Mailing Address - Fax:
Practice Address - Street 1:245 N 15TH ST RM 5401
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19102-1101
Practice Address - Country:US
Practice Address - Phone:267-259-2518
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:DREXEL UNIVERISTY
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-05-05
Last Update Date:2025-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207ZP0105XAllopathic & Osteopathic PhysiciansPathologyClinical Pathology/Laboratory MedicineGroup - Single Specialty