| Thomas Jefferson University Psych | |
|
833 Chestnut St Ste 630 Philadelphia PA 19107-4416 | |
| (215) 955-0800 | |
| Not Available |
| Full Name | Thomas Jefferson University Psych |
|---|---|
| Speciality | Psychiatry & Neurology - Child & Adolescent Psychiatry |
| Location | 833 Chestnut St Ste 630, Philadelphia, Pennsylvania |
| Authorized Official Name and Position | John Ogunkeye (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 2159552562 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Thomas Jefferson University Psych 833 Chestnut St Ste 630 Philadelphia PA 19107-4416 Ph: (215) 955-0800 | Thomas Jefferson University Psych 833 Chestnut St Ste 630 Philadelphia PA 19107-4416 Ph: (215) 955-0800 |
| NPI Number | 1578723839 |
|---|---|
| Provider Enumeration Date | 06/11/2008 |
| Last Update Date | 06/11/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1578723839 | NPI | - | NPPES |
| 1007571300088 | Medicaid | PA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0804X | Psychiatry & Neurology - Child & Adolescent Psychiatry | (* (Not Available)) | Primary |
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