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General NPI Number Information
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NPI Number | 1093995003
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Entity Type | Organization
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Legal Business Name | BRUCE K BROWNSTEIN, MD
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Dates
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Enumeration Date | 11/07/2007
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Last Update Date | 11/07/2007
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Provider Practice Location Address
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Address Line | 1 PENN BLVD SUITE102
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City | PHILADELPHIA
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State | PA
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Zip | 19144-1476
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Country | US
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Telephone | 215-438-3030
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Fax | 215-951-8985
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Provider Business Mailing Address
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Address Line | 1 PENN BLVD SUITE102
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City | PHILADELPHIA
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State | PA
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Zip | 19144-1476
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Country | US
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Telephone | 215-438-3030
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Fax | 215-951-8985
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Authorized Official
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Title or Position | OWNER
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Name | BRUCE KEITH BROWNSTEIN
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Credential | MD
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Telephone | 215-438-2020
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | MD020980E
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License Number State | PA
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