| Bralow Medical Group | |
|
834 South St. Philadelphia PA 19147 | |
| (610) 986-4827 | |
| (610) 660-0877 |
| Full Name | Bralow Medical Group |
|---|---|
| Speciality | General Practice |
| Location | 834 South St., Philadelphia, Pennsylvania |
| Authorized Official Name and Position | Vicki L Bralow (PRESIDENT) |
| Authorized Official Contact | 6109864827 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Bralow Medical Group 834 South Street Philadelphia PA 19147 Ph: (610) 986-4827 | Bralow Medical Group 834 South St. Philadelphia PA 19147 Ph: (610) 986-4827 |
| NPI Number | 1023556875 |
|---|---|
| Provider Enumeration Date | 02/01/2017 |
| Last Update Date | 02/28/2017 |
| Medicare PECOS PAC ID | 4880961838 |
|---|---|
| Medicare Enrollment ID | O20170524000131 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1023556875 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | OS006570L (Pennsylvania) | Primary |
| Provider Name | Vicki L Bralow |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1962588335 PECOS PAC ID: 5496940942 Enrollment ID: I20101110001067 |
| Provider Name | Scott A Bralow |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1174586358 PECOS PAC ID: 7810932381 Enrollment ID: I20110316000256 |
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