Provider Demographics
NPI:1164413423
Name:BRASLOW, NORMAN (MD)
Entity Type:Individual
Prefix:DR
First Name:NORMAN
Middle Name:
Last Name:BRASLOW
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1088 W BALTIMORE PIKE STE 2202
Mailing Address - Street 2:
Mailing Address - City:MEDIA
Mailing Address - State:PA
Mailing Address - Zip Code:19063-5136
Mailing Address - Country:US
Mailing Address - Phone:484-442-8235
Mailing Address - Fax:484-443-8039
Practice Address - Street 1:1088 W BALTIMORE PIKE STE 2202
Practice Address - Street 2:
Practice Address - City:MEDIA
Practice Address - State:PA
Practice Address - Zip Code:19063-5136
Practice Address - Country:US
Practice Address - Phone:484-442-8235
Practice Address - Fax:484-443-8039
Is Sole Proprietor?:No
Enumeration Date:2005-11-04
Last Update Date:2022-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD020640207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAC28222Medicare UPIN