OrganizationActive
Upenn Life
NPI 1053576835 · Health Maintenance Organization · Philadelphia, PA
Provider details
- NPI number
- 1053576835
- Entity type
- Organization
- Primary specialty
- Health Maintenance OrganizationManaged Care Organizations
- Parent organization
- Upenn School of Nursing
- Organization subpart
- Yes
- Authorized official
- Bruce Kinosian, Medical Director(215) 573-7200
- License
- MD421701 (PA)
Specialties & taxonomies
Managed Care Organizations
Practice location
4508 Chestnut St
Philadelphia, PA 19139-3608
Phone: (215) 573-7200
Approximate (ZIP-level) locationGet directions
Mailing address
4508 Chestnut St
Philadelphia, PA 19139-3608
Registry dates
- Enumerated
- 2008-07-22
- Last updated
- 2008-07-22
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.