Healthcare Provider Details

I. General information

NPI: 1073192233
Provider Name (Legal Business Name): BRIANNA BOCKMAN WU MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: BRIANNA BOCKMAN

II. Dates (important events)

Enumeration Date: 04/05/2021
Last Update Date: 12/01/2025
Certification Date: 12/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

155 S ARCH ST
MILTON PA
17847-1172
US

IV. Provider business mailing address

100 N ACADEMY AVE
DANVILLE PA
17822-9800
US

V. Phone/Fax

Practice location:
  • Phone: 570-742-2655
  • Fax: 570-742-2886
Mailing address:
  • Phone: 570-742-2655
  • Fax: 570-742-2886

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberMD490612
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: