Provider Demographics
NPI:1528235231
Name:TELLEFSEN, LINDSAY REDICAN
Entity type:Individual
Prefix:DR
First Name:LINDSAY
Middle Name:REDICAN
Last Name:TELLEFSEN
Suffix:
Gender:F
Credentials:
Other - Prefix:DR
Other - First Name:LINDSAY
Other - Middle Name:ALISON
Other - Last Name:REDICAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:100 E PENN SQ
Mailing Address - Street 2:9TH FL
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19107-3323
Mailing Address - Country:US
Mailing Address - Phone:267-425-9232
Mailing Address - Fax:267-425-9299
Practice Address - Street 1:1648 HUNTINGDON PIKE
Practice Address - Street 2:CHOP CARE NETWORK AT HOLY REDEEMER HOSPITAL
Practice Address - City:MEADOWBROOK
Practice Address - State:PA
Practice Address - Zip Code:19046-8001
Practice Address - Country:US
Practice Address - Phone:215-938-2903
Practice Address - Fax:215-938-2905
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-12
Last Update Date:2014-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD434200208000000X, 2080N0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080N0001XAllopathic & Osteopathic PhysiciansPediatricsNeonatal-Perinatal Medicine
No208000000XAllopathic & Osteopathic PhysiciansPediatrics