Provider Demographics
NPI:1083831283
Name:HYMOWITZ, BRIAN E (DC)
Entity Type:Individual
Prefix:DR
First Name:BRIAN
Middle Name:E
Last Name:HYMOWITZ
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1262 WOOD LN
Mailing Address - Street 2:SUITE 205
Mailing Address - City:LANGHORNE
Mailing Address - State:PA
Mailing Address - Zip Code:19047-1769
Mailing Address - Country:US
Mailing Address - Phone:215-750-3132
Mailing Address - Fax:215-750-2792
Practice Address - Street 1:1262 WOOD LN
Practice Address - Street 2:SUITE 205
Practice Address - City:LANGHORNE
Practice Address - State:PA
Practice Address - Zip Code:19047-1769
Practice Address - Country:US
Practice Address - Phone:215-750-3132
Practice Address - Fax:215-750-2792
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC009246111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA086413Medicare ID - Type Unspecified