Provider Demographics
NPI:1992908990
Name:THOMAS JEFFERSON UNIVERSITY HOSPITAL
Entity type:Organization
Organization Name:THOMAS JEFFERSON UNIVERSITY HOSPITAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:RESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SANDARSH
Authorized Official - Middle Name:RAJ
Authorized Official - Last Name:KANCHERLA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:215-955-6060
Mailing Address - Street 1:1011 CHESTNUT ST
Mailing Address - Street 2:APT 801WEST
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19107-1421
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1011 CHESTNUT ST
Practice Address - Street 2:APT 801WEST
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19107-1421
Practice Address - Country:US
Practice Address - Phone:215-955-6060
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-07
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital