UNIVERSITY OF PENN-MEDICAL GROUP (NPI# 1164810271) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1164810271 |
| Entity Type | Organization |
| Organization Name | UNIVERSITY OF PENN-MEDICAL GROUP |
| Practice Address |
3400 Civic Center Blvd 2nd Floor South Pavillion Philadelphia PA 19104-5127 |
| Practice Telephone | 2156623606 |
| Mailing Telephone | 2156623606 |
| Enumeration Date | 2014-12-26 |
| Last Update Date | 2015-07-21 |
| Authorized Official Name | ELIZABETH JOHNSTON (EXECUTIVE DIRECTOR) |
| Authorized Official Telephone | 2156627583 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2084N0400X |
Psychiatry & Neurology Specialization: Neurology |
PA | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396193900 | University of Penn-medical Group | Transplant Surgery | 1501 N Cedar Crest Blvd, Suite 110 Liver Transplant, Allentown, PA 18104-2309 | 2016-05-25 |
| 1821451139 | University of Penn-medical Group | Internal Medicine | 554 N Duke St, 3rd Floor Renal Transplant, Lancaster, PA 17602-2225 | 2016-04-04 |
| 1902269210 | University of Penn-medical Group | Surgery | 554 N Duke St, 3rd Floor, Lancaster, PA 17602-2225 | 2016-04-04 |
| 1043670805 | University of Penn-medical Group | Internal Medicine | 554 N Duke St, 3rd Floor Gi Transplant, Lancaster, PA 17602-2225 | 2016-03-07 |
| 1730578667 | University of Penn-medical Group | Internal Medicine | 3400 Spruce St, Ground Floor Donner, Philadelphia, PA 19104-4238 | 2015-01-15 |
| 1073902169 | University of Penn-medical Group | Dermatology | 3400 Spruce St, 2 Rhoads Pavilion, Philadelphia, PA 19104-4238 | 2015-01-13 |
| 1184012569 | University of Penn-medical Group | Clinical Medical Laboratory | 3400 Spruce St, Philadelphia, PA 19104-4238 | 2015-01-07 |
| 1821486846 | University of Penn-medical Group | Marriage & Family Therapist | 3535 Market St, 3rd Floor, Philadelphia, PA 19104-3309 | 2014-12-29 |
| 1740678762 | University of Penn-medical Group | Pathology | 3400 Spruce St, Philadelphia, PA 19104-4238 | 2014-12-29 |
| 1811385834 | University of Penn-medical Group | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 51 N 39th St, 266 Wright Saunders, Philadelphia, PA 19104-2640 | 2014-12-29 |
| Street Address |
3400 CIVIC CENTER BLVD 2ND FLOOR SOUTH PAVILLION |
| City | PHILADELPHIA |
| State | PA |
| Zip Code | 19104-5127 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124027727 | Joel D Glickman | Internal Medicine | 3400 Civic Center Blvd, 1st Floor, Suite 300 S, Philadelphia, PA 19104-4306 | 2005-07-18 |
| 1841891058 | Abigail Brooke Horowitz | Nurse Practitioner | 3400 Civic Center Blvd, Philadelphia, PA 19104-5127 | 2020-11-04 |
| 1073129532 | Samuel Kovell | Physician Assistant | 3400 Civic Center Blvd, Philadelphia, PA 19104-5127 | 2020-09-21 |
| 1306451695 | Farzad Nourollah-zadeh | Oral Medicinist | 3400 Civic Center Blvd, Philadelphia, PA 19104-5127 | 2020-09-13 |
| 1609492917 | Mosetta Harris | Nurse Practitioner | 3400 Civic Center Blvd, Philadelphia, PA 19104-5127 | 2020-06-23 |
| 1063032530 | Monique Maria Tee | Internal Medicine | 3400 Civic Center Blvd, Philadelphia, PA 19104-5127 | 2020-04-24 |
| 1609495290 | Katharine Freeman Michel | Student in an Organized Health Care Education/Training Program | 3400 Civic Center Blvd, 3rd Floor West Pavilion, Philadelphia, PA 19104 | 2020-04-13 |
| 1609495498 | Taha Samir Ghouleh | Student in an Organized Health Care Education/Training Program | 3400 Civic Center Blvd, Philadelphia, PA 19104-5127 | 2020-04-11 |
| 1952930554 | Danielle Marie Lamarra | Nurse Practitioner | 3400 Civic Center Blvd, Philadelphia, PA 19104-5127 | 2020-04-06 |
| 1982232658 | Jasmine Hwang | Student in an Organized Health Care Education/Training Program | 3400 Civic Center Blvd, Philadelphia, PA 19104-5127 | 2020-03-30 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639770829 | Michelle Morris | Student in an Organized Health Care Education/Training Program | Dept. of Family Medicine & Community Health, 3737 Market, Philadelphia, PA 19104 | 2020-11-04 |
| 1346853041 | Spectrum Health Services, Inc. | Clinic/Center | 1415 South University Ave, Philadelphia, PA 19104 | 2020-08-24 |
| 1770104259 | Fatimah Sorefan-mangou | Student in an Organized Health Care Education/Training Program | 4 Maloney 3400 Spruce Street, Philadelphia, PA 19104 | 2020-05-06 |
| 1114548690 | Rebecca Blaguski | Registered Nurse | The Hospital of The University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA 19104 | 2020-05-06 |
| 1952944175 | Rebecca Miriam Barmherzig | Psychiatry & Neurology | 3501 Civic Centre Blvd, 10th Flr Ctrb, Neurology, Philadelphia, PA 19104 | 2019-10-21 |
| 1891257101 | James Paul Byrne | Surgery | Penn Presbyterian Medical Center, Division of Trauma, S, 51 N. 39th Street, Suite 120, 1st Floor Medical Office, Philadelphia, PA 19104 | 2019-04-04 |
| 1093276453 | Lauren Shreve | Student in an Organized Health Care Education/Training Program | Department of Surgery, Surgery Education - Penn Health, 3400 Spruce Street, 4 Maloney, Philadelphia, PA 19104 | 2019-03-28 |
| 1285194282 | Lauren M Christie | Student in an Organized Health Care Education/Training Program | Penn Presbyterian Medical Center, 51 N. 39th Street, Philadelphia, PA 19104 | 2019-03-25 |
| 1114487683 | Sabrina Layne | Student in an Organized Health Care Education/Training Program | 3400 Spruce Street, 100 Centrex, Philadelphia, PA 19104 | 2019-03-21 |
| 1811457310 | Kia Lor | Student in an Organized Health Care Education/Training Program | Hospital of University of Pennsylvania, 3400 Spruce St., Philadelphia, PA 19104 | 2019-03-21 |
| Find all providers in zip 19104 | ||||
| Taxonomy Code | 2084N0400X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Neurology |
| A Neurologist specializes in the diagnosis and treatment of diseases or impaired function of the brain, spinal cord, peripheral nerves, muscles, autonomic nervous system, and blood vessels that relate to these structures. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972060176 | Ncv Diagnostics LLC | Psychiatry & Neurology | 1 Brown St Ste C, Philadelphia, PA 19123-3361 | 2019-02-23 |
| 1982102133 | Sonia Anand-nichols Md PC | Psychiatry & Neurology | 5735 Ridge Ave Ste 101, Philadelphia, PA 19128-1746 | 2018-01-23 |
| 1205357886 | Kenneth Gross | Psychiatry & Neurology | 777 S Broad St Apt 412, Philadelphia, PA 19147-2509 | 2017-07-04 |
| 1417339409 | Leonel Jorge Favio Estofan | Psychiatry & Neurology | 245 N 15th St, 7th Floor, Philadelphia, PA 19102-1200 | 2015-06-25 |
| 1073900700 | Pavan Anil Vaswani | Psychiatry & Neurology | 330 S 9th St Fl 3, Philadelphia, PA 19107-6103 | 2015-04-21 |
| 1942613369 | Mia Chwan Ko | Psychiatry & Neurology | 5401 Old York Rd Ste 404, Philadelphia, PA 19141-3046 | 2014-06-03 |
| 1912340415 | Simy Kabaria Parikh | Psychiatry & Neurology | 900 Walnut St Ste 200, Philadelphia, PA 19107-5191 | 2013-04-15 |
| 1215295118 | Curtis Brandon Allumbaugh | Psychiatry & Neurology | 833 Chestnut St Ste 220, Philadelphia, PA 19107 | 2012-04-27 |
| 1013201870 | Enrique Aradillas Lopez | Psychiatry & Neurology | 1200 Constitution Ave Ste 110, Philadelphia, PA 19112-1323 | 2011-06-08 |
| 1598076358 | Hristelina S. Ilieva | Psychiatry & Neurology | 909 Walnut Street 2nd Floor, Philadelphia, PA 19107-3342 | 2010-06-27 |
| Find all providers in PHILADELPHIA | ||||
| City | PHILADELPHIA |
| Zip Code | 19104 |
Please comment or provide details below to improve the information on UNIVERSITY OF PENN-MEDICAL GROUP.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.