Healthcare Provider Details

I. General information

NPI: 1659809101
Provider Name (Legal Business Name): EMILY RUTH BROOMELL BURNETT DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: EMILY R BROOMELL

II. Dates (important events)

Enumeration Date: 05/30/2017
Last Update Date: 06/29/2026
Certification Date: 06/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

728 WEST LINCOLN HIGHWAY, 2ND FLOOR THE COMMONS AT THE OAKLANDS
EXTON PA
19341-2547
US

IV. Provider business mailing address

728 WEST LINCOLN HIGHWAY, 2ND FLOOR THE COMMONS AT THE OAKLANDS
EXTON PA
19341-2547
US

V. Phone/Fax

Practice location:
  • Phone: 610-903-6200
  • Fax: 610-903-6201
Mailing address:
  • Phone: 610-903-6200
  • Fax: 610-903-6201

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberOS021509
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: