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General NPI Number Information
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NPI Number | 1205832177
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Entity Type | Organization
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Legal Business Name | DAVID BRONSTEIN DO RICHARD H JEFFRIES DO PROFESSIONAL ASSOC
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Dates
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Enumeration Date | 06/24/2005
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 4830 LONDONDERRY RD
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City | HARRISBURG
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State | PA
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Zip | 17109-5207
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Country | US
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Telephone | 717-657-2595
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Fax | 717-441-0116
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Provider Business Mailing Address
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Address Line | 4830 LONDONDERRY RD
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City | HARRISBURG
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State | PA
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Zip | 17109-5207
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Country | US
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Telephone | 717-657-2595
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Fax | 717-441-0116
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. DAVID BRONSTEIN
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Credential | D.O.
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Telephone | 717-657-2595
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RH0003X
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Taxonomy Name | Hematology & Oncology Physician
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License Number |
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 207RI0200X
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Taxonomy Name | Infectious Disease Physician
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License Number |
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License Number State | PA
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Taxonomy #3
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number |
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License Number State | PA
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Taxonomy #4
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State | PA
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