Provider Demographics
NPI:1891730255
Name:BRIKER, VIKTOR (OD)
Entity type:Individual
Prefix:DR
First Name:VIKTOR
Middle Name:
Last Name:BRIKER
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:842 RED LION RD
Mailing Address - Street 2:SUITE 18
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19115
Mailing Address - Country:US
Mailing Address - Phone:215-856-9810
Mailing Address - Fax:215-856-9820
Practice Address - Street 1:842 RED LION RD
Practice Address - Street 2:SUITE 18
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19115
Practice Address - Country:US
Practice Address - Phone:215-856-9810
Practice Address - Fax:215-856-9820
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOEG000084152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1769052Medicaid
PA2338844OtherAETNA
PA019214Medicare ID - Type Unspecified
U72922Medicare UPIN