MEDICARE: DR.VIKTOR BRIKER P.C.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QH0100X	Health Service Clinic/Center	0EG000084	PA

General Provider Information

NPI Number	:	1659532752
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DR.VIKTOR BRIKER P.C.

Provider Business Mailing Address
First Line	:	842 RED LION RD STE 18
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19115-1475
Country	:	US
Telephone Number	:	215-856-9810
Fax Number	:	215-856-9820

Provider Business Practice Location Address
First Line	:	842 RED LION RD STE 18
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19115-1475
Country	:	US
Telephone Number	:	215-856-9810
Fax Number	:	215-856-9820

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. VIKTOR BRIKER
Credential	:	OD
Telephone Number	:	215-355-6197

Provider Enumeration Date	:	06/20/2008
Last Update Date	:	06/27/2008

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