Healthcare Provider Details

I. General information

NPI: 1215988621
Provider Name (Legal Business Name): NORMAN A BREST MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/12/2006
Last Update Date: 05/24/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 E LANCASTER AVE LANKENAU MEDICAL BLDG EAST SUITE 561
WYNNEWOOD PA
19096-3450
US

IV. Provider business mailing address

100 E LANCASTER AVE LANKENAU MEDICAL BLDG EAST SUITE 561
WYNNEWOOD PA
19096-3450
US

V. Phone/Fax

Practice location:
  • Phone: 610-642-7714
  • Fax: 610-649-0761
Mailing address:
  • Phone: 610-642-7714
  • Fax: 610-649-0761

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberMD024417E
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: