Provider Demographics
NPI:1528108297
Name:UNIVERSITY OF PENNSYLVANIA HEALTH SYSTEM
Entity type:Organization
Organization Name:UNIVERSITY OF PENNSYLVANIA HEALTH SYSTEM
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ATTENDING PHYSICIAN/ELECTROPHYSIOLO
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:BULLINGA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:215-612-9736
Mailing Address - Street 1:39TH & MARKET STREETS
Mailing Address - Street 2:PHI-2
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19104
Mailing Address - Country:US
Mailing Address - Phone:215-662-9736
Mailing Address - Fax:
Practice Address - Street 1:39TH & MARKET STREETS
Practice Address - Street 2:PHI-2
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19104
Practice Address - Country:US
Practice Address - Phone:215-662-9736
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-08
Last Update Date:2007-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMA052840282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital