Provider Demographics
NPI:1215988621
Name:BREST, NORMAN A (MD)
Entity type:Individual
Prefix:DR
First Name:NORMAN
Middle Name:A
Last Name:BREST
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:100 E LANCASTER AVE
Mailing Address - Street 2:LANKENAU MEDICAL BLDG EAST SUITE 561
Mailing Address - City:WYNNEWOOD
Mailing Address - State:PA
Mailing Address - Zip Code:19096-3450
Mailing Address - Country:US
Mailing Address - Phone:610-642-7714
Mailing Address - Fax:610-649-0761
Practice Address - Street 1:100 E LANCASTER AVE
Practice Address - Street 2:LANKENAU MEDICAL BLDG EAST SUITE 561
Practice Address - City:WYNNEWOOD
Practice Address - State:PA
Practice Address - Zip Code:19096-3450
Practice Address - Country:US
Practice Address - Phone:610-642-7714
Practice Address - Fax:610-649-0761
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-12
Last Update Date:2012-05-24
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAMD024417E207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA2666235OtherAETNA HEALTHPLAN
PABR038051OtherPENNSLYVANIA BLUE SHIELD
PA2346689000OtherINDEPENDENCE BLUE CROSS
PABR038051OtherPENNSLYVANIA BLUE SHIELD
PABR038051Medicare ID - Type Unspecified