Provider Demographics
NPI:1992751044
Name:BRNDJAR MEDICAL ASSOCIATES,P.C.
Entity type:Organization
Organization Name:BRNDJAR MEDICAL ASSOCIATES,P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:DANA
Authorized Official - Middle Name:M
Authorized Official - Last Name:BRNDJAR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:610-965-1900
Mailing Address - Street 1:730 HARRISON ST
Mailing Address - Street 2:
Mailing Address - City:EMMAUS
Mailing Address - State:PA
Mailing Address - Zip Code:18049-2211
Mailing Address - Country:US
Mailing Address - Phone:610-965-1900
Mailing Address - Fax:610-965-2900
Practice Address - Street 1:730 HARRISON ST
Practice Address - Street 2:
Practice Address - City:EMMAUS
Practice Address - State:PA
Practice Address - Zip Code:18049-2211
Practice Address - Country:US
Practice Address - Phone:610-965-1900
Practice Address - Fax:610-965-2900
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-26
Last Update Date:2011-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS007814L207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA01511777Medicaid
PAG00312Medicare UPIN
PA63334RPDMedicare PIN