Provider Demographics
NPI:1861725608
Name:JEFFERSON UNIVERSITY HOSPITAL
Entity type:Organization
Organization Name:JEFFERSON UNIVERSITY HOSPITAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:RHEUMATOLOGY CHIEF & DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:OSCAR
Authorized Official - Middle Name:
Authorized Official - Last Name:IRIGOYEN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:215-955-1410
Mailing Address - Street 1:211 S 9TH ST
Mailing Address - Street 2:SUITE 600,WALNUT TOWERS
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19107-6810
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1015 WALNUT ST
Practice Address - Street 2:1015 WALNUT STREET
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19107-5005
Practice Address - Country:US
Practice Address - Phone:215-955-4516
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-11
Last Update Date:2009-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMT188493261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center