Healthcare Provider Details

I. General information

NPI: 1831372978
Provider Name (Legal Business Name): NORMAN A. BREST, MD DIVISON
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/12/2007
Last Update Date: 12/12/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

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

IV. Provider business mailing address

100 E LANCASTER AVE 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: DR. NORMAN A BREST
Title or Position: DIVISION OWNER
Credential: MD
Phone: 610-642-7714