Provider Demographics
NPI:1669620407
Name:JEFFERSON UNIVERSITY PHYSICIANS
Entity type:Organization
Organization Name:JEFFERSON UNIVERSITY PHYSICIANS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ANESTHESIA DEPARTMENT HEAD
Authorized Official - Prefix:
Authorized Official - First Name:ZVI
Authorized Official - Middle Name:
Authorized Official - Last Name:GRUNWALD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:215-955-5848
Mailing Address - Street 1:26 MORNINGSTAR CT
Mailing Address - Street 2:
Mailing Address - City:SICKLERVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08081-4926
Mailing Address - Country:US
Mailing Address - Phone:856-374-2288
Mailing Address - Fax:
Practice Address - Street 1:111 S 11TH ST
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19107-4824
Practice Address - Country:US
Practice Address - Phone:215-955-4038
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-05
Last Update Date:2008-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN524937L282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital