THOMAS JEFFERSON UNIVERSITY PSYCH (NPI# 1578723839) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1578723839 |
| Entity Type | Organization |
| Organization Name | THOMAS JEFFERSON UNIVERSITY PSYCH |
| Practice Address |
833 Chestnut St Ste 630 Philadelphia PA 19107-4416 |
| Practice Telephone | 2159550800 |
| Mailing Telephone | 2159550800 |
| Enumeration Date | 2008-06-11 |
| Last Update Date | 2008-06-11 |
| Authorized Official Name | MR. JOHN OGUNKEYE (EXECUTIVE DIRECTOR) |
| Authorized Official Telephone | 2159552562 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2084P0804X |
Psychiatry & Neurology Specialization: Child & Adolescent Psychiatry |
Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PA | 1007571300088 | 05 |
| Street Address |
833 CHESTNUT ST STE 630 |
| City | PHILADELPHIA |
| State | PA |
| Zip Code | 19107-4416 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578170940 | Stephanie Quist | Pharmacist | 1 S Broad Street, Philadelphia, PA 19107 | 2020-09-29 |
| 1457968448 | Cloudline Physical Therapy LLC | Physical Therapist | 239-241 South 10th St, Philadelphia, PA 19107 | 2020-09-24 |
| 1053931303 | Wilson Wong | Pharmacist | Cvs Pharmacy #450, 3401 Walnut St, Philadelphia, PA 19107 | 2020-04-16 |
| 1326608779 | Pascal Lavergne | Neurological Surgery | 111 11th St, Thomas Jefferson University, Philadelphia, PA 19107 | 2019-06-18 |
| 1639632185 | Taylor D'amore | Orthopaedic Surgery | 925 Chest Street 5th Floor, Philadelphia, PA 19107 | 2019-04-11 |
| 1043779630 | Heather Lynn Yenser | Nurse Practitioner | 111 S. 11th St., Jefferson Vascular Center (6th Floor), Philadelphia, PA 19107 | 2019-03-14 |
| 1174093702 | Jennifer Lynn Kengeter | Psychologist | 900 Walnut Street, Suite 200, Philadelphia, PA 19107 | 2018-11-27 |
| 1649751843 | Rachel Wint | Physician Assistant | 231 N Broad St Fl 2, Philadelphia, PA 19107 | 2018-08-24 |
| 1922588623 | Hyung Bin Lee | Dentist | 315 N 12th St, Apt 803, Philadelphia, PA 19107 | 2018-08-21 |
| 1750860490 | Anastasiya Khlypnych | Physician Assistant | 111 S. 11th Street, Suite 2170, Gibbon Bldg Suite 6210, Philadelphia, PA 19107 | 2018-08-13 |
| Find all providers in zip 19107 | ||||
| Taxonomy Code | 2084P0804X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Child & Adolescent Psychiatry |
| Child & Adolescent Psychiatry is a subspecialty of psychiatry with additional skills and training in the diagnosis and treatment of developmental, behavioral, emotional, and mental disorders of childhood and adolescence. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902440621 | Eastern Pennsylvania Physician Alliance LLC | Psychiatry & Neurology | 4641 E Roosevelt Blvd, Philadelphia, PA 19124-2343 | 2019-11-06 |
| 1982083366 | Jaclyn Chua | Psychiatry & Neurology | 3440 Market St Ste 200, Philadelphia, PA 19104-3336 | 2015-05-19 |
| 1295175602 | Grace Unsal | Psychiatry & Neurology | Belmont Behavioral Hospital, LLC, 4200 Monument Road, Philadelphia, PA 19131 | 2013-06-29 |
| 1437463783 | Gordon R. Hodas | Psychiatry & Neurology | 8104 Germantown Ave, Philadelphia, PA 19118-3423 | 2010-07-28 |
| 1063731388 | Marc A. Forman | Psychiatry & Neurology | 233 S. 6th St, Philadelphia, PA 19106-3756 | 2010-05-26 |
| 1346464880 | Manely Ghaffari | Psychiatry & Neurology | 129 N 4th St, Office 1f, Philadelphia, PA 19106-1817 | 2007-04-13 |
| 1700954922 | Neurology Associates Ltd | Psychiatry & Neurology | 1514 Wolf St, Philadelphia, PA 19145-4441 | 2006-12-04 |
| 1912088667 | Linda Diane Gordon | Psychiatry & Neurology | 801 Market Street, Community Behavioral Health, 7th Floor, Philadelphia, PA 19107 | 2006-10-18 |
| 1821182726 | Katie L. Hoeveler | Psychiatry & Neurology | 3440 Market Street, 4th Floor, The Children's Hospital of Philadelphia, Philadelphia, PA 19104 | 2006-10-03 |
| 1235169897 | Aurora M Casta | Psychiatry & Neurology | 133 S 36th St, Philadelphia, PA 19104-3201 | 2006-07-03 |
| Find all providers in PHILADELPHIA | ||||
| City | PHILADELPHIA |
| Zip Code | 19107 |
Please comment or provide details below to improve the information on THOMAS JEFFERSON UNIVERSITY PSYCH.
| 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.