Provider Demographics
NPI:1033476015
Name:BOBZIEN, BRENDAN FRANCIS
Entity Type:Individual
Prefix:
First Name:BRENDAN
Middle Name:FRANCIS
Last Name:BOBZIEN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2151 S 19TH ST
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19145-3709
Mailing Address - Country:US
Mailing Address - Phone:215-681-0337
Mailing Address - Fax:
Practice Address - Street 1:2151 S 19TH ST
Practice Address - Street 2:2ND FLOOR
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19145-3709
Practice Address - Country:US
Practice Address - Phone:215-681-0337
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-16
Last Update Date:2012-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health