Penn Executive Diagnostic Center, Inc.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

PENN EXECUTIVE DIAGNOSTIC CENTER, INC.

Practice address

1801 Market St
Suite 200
Philadelphia, PA 19103-1628

Phone

(215) 569-9500

Fax

(215) 569-4839

NPI assigned

Nov 17, 2006

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Ms. Carol Sue Klein, BA, MA, MBA

Title

Vice President

Phone

(215) 569-9500

Specialties & licenses 1

Addresses

Tax ID family

Penn Executive Diagnostic Center Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Penn Executive Diagnostic Center, Inc.

  • Multi-Specialty Clinic/Center
  • Philadelphia, PA
  • NPI 1881649721
  NPD tax ID

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• William Scott Hauptman, M.D.

  • Internal Medicine Physician
  • Philadelphia, PA
  • NPI 1548358211
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1163721600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1639242399",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1801 MARKET ST",
            "address_2": "SUITE 200",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191031628",
            "telephone_number": "215-569-9500",
            "fax_number": "215-569-4839"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1801 MARKET ST",
            "address_2": "SUITE 200",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191031628",
            "telephone_number": "215-569-9500",
            "fax_number": "215-569-4839"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PENN EXECUTIVE DIAGNOSTIC CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-17",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "KLEIN",
        "authorized_official_first_name": "CAROL",
        "authorized_official_middle_name": "SUE",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "215-569-9500",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "BA, MA, MBA"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Penn Asian Senior Services, Inc.
• Penn Center for Rehabiliation and Care
• Penn Dental Center PC
• Penn Diagnostic Co.
• Penn Ergonomics, LLC
• Penn Executive Diagnostic Center, Inc.
• Penn Hope Transport Inc
• Penn House Homecare LLC
• Penn Integrative Medical and Dental Center, Inc.
• Penn Medical Associates PC (Philadelphia Pulsewave)

• Internal Medicine Physician in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Internal Medicine Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.