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NPI Code Detail

MEDICARE: JENNIFER E BRUBAKER M.D.

MEDICARE: JENNIFER E BRUBAKER M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1208000000XPediatrics PhysicianMD00041377WA
2208000000XPediatrics PhysicianMD451788PA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1912927179
Entity Type Code : Individual
Provider Name (Legal Business Name) : JENNIFER E BRUBAKER M.D.
Provider Business Mailing Address
First Line : 304 N WATER ST
Second Line :
City : LANCASTER
State : PA
Zip : 17603-3374
Country : US
Telephone Number : 717-735-6808
Fax Number : 717-945-1587
Provider Business Practice Location Address
First Line : 304 N WATER ST
Second Line :
City : LANCASTER
State : PA
Zip : 17603-3374
Country : US
Telephone Number : 717-299-6372
Fax Number : 717-945-1587
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/20/2006
Last Update Date : 03/17/2018

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