Healthcare Provider Details

I. General information

NPI: 1033407168
Provider Name (Legal Business Name): BRIAN J. KERN MA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/11/2011
Last Update Date: 07/11/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6253 SANDY CT
NEW TRIPOLI PA
18066-3649
US

IV. Provider business mailing address

6253 SANDY CT
NEW TRIPOLI PA
18066-3649
US

V. Phone/Fax

Practice location:
  • Phone: 484-553-0218
  • Fax:
Mailing address:
  • Phone: 484-553-0218
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP1600X
TaxonomyPastoral Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: