Basic Information
| Provider Information | |||||||||
| NPI: | 1649651340 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ALLERTON | ||||||||
| FirstName: | BRIANNE | ||||||||
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| Credential: | D.O. | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 783311 | ||||||||
| Address2: | |||||||||
| City: | PHILADELPHIA | ||||||||
| State: | PA | ||||||||
| PostalCode: | 191783311 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4848844500 | ||||||||
| FaxNumber: | 4848840699 | ||||||||
| Practice Location | |||||||||
| Address1: | 863 NAZARETH PIKE | ||||||||
| Address2: | |||||||||
| City: | NAZARETH | ||||||||
| State: | PA | ||||||||
| PostalCode: | 180649001 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4843733260 | ||||||||
| FaxNumber: | 4843733128 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/18/2015 | ||||||||
| LastUpdateDate: | 10/01/2019 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | OS019560 | PA | Y | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.