Provider Demographics
NPI:1093740011
Name:DECHOWITZ, BRIAN ALAN (DPM)
Entity Type:Individual
Prefix:DR
First Name:BRIAN
Middle Name:ALAN
Last Name:DECHOWITZ
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:127 PINE ST
Mailing Address - Street 2:
Mailing Address - City:HARRISBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17101-1240
Mailing Address - Country:US
Mailing Address - Phone:717-238-1445
Mailing Address - Fax:717-238-1446
Practice Address - Street 1:127 PINE ST
Practice Address - Street 2:
Practice Address - City:HARRISBURG
Practice Address - State:PA
Practice Address - Zip Code:17101-1240
Practice Address - Country:US
Practice Address - Phone:717-238-1445
Practice Address - Fax:717-238-1446
Is Sole Proprietor?:No
Enumeration Date:2006-07-11
Last Update Date:2011-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASC002835L213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA126332Medicaid
T29322Medicare UPIN
PA126332Medicaid