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General NPI Number Information
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NPI Number | 1871768234
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Entity Type | Individual
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Provider Name | BROOKE DEVENNEY MD
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Gender | Female
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Dates
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Enumeration Date | 04/28/2008
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Last Update Date | 07/06/2018
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Provider Practice Location Address
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Address Line | 559 W GERMANTOWN PIKE EINSTEIN RADIOLOGY ASSOCIATES
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City | EAST NORRITON
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State | PA
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Zip | 19403
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Country | US
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Telephone | 484-622-0746
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Fax | 484-622-0643
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Provider Business Mailing Address
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Address Line | 559 W GERMANTOWN PIKE EINSTEIN RADIOLOGY ASSOCIATES
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City | EAST NORRITON
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State | PA
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Zip | 19403
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Country | US
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Telephone | 484-622-0746
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Fax | 484-622-0643
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 229383
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License Number State | MA
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