Healthcare Provider Details

I. General information

NPI: 1568761062
Provider Name (Legal Business Name): BROKER,CRAMER & SWANSON ENT, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/23/2011
Last Update Date: 09/17/2024
Certification Date: 09/17/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

826 MAIN ST SUITE 201
PHOENIXVILLE PA
19460-4459
US

IV. Provider business mailing address

826 MAIN ST SUITE 201
PHOENIXVILLE PA
19460-4459
US

V. Phone/Fax

Practice location:
  • Phone: 610-415-1100
  • Fax: 610-415-1101
Mailing address:
  • Phone: 610-415-1100
  • Fax: 610-415-1101

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207K00000X
TaxonomyAllergy & Immunology Physician
License NumberMD433243
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code207YX0905X
TaxonomyOtolaryngology/Facial Plastic Surgery Physician
License NumberMD053007L
License Number StatePA

VIII. Authorized Official

Name: BRIAN BROKER
Title or Position: PRESIDENT
Credential:
Phone: 610-415-1100