Provider Demographics
NPI:1386213221
Name:BRANNIGAN, BRIAN T (HEARING SPECIALIST)
Entity Type:Individual
Prefix:
First Name:BRIAN
Middle Name:T
Last Name:BRANNIGAN
Suffix:
Gender:M
Credentials:HEARING SPECIALIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 686
Mailing Address - Street 2:
Mailing Address - City:HORSHAM
Mailing Address - State:PA
Mailing Address - Zip Code:19044-0686
Mailing Address - Country:US
Mailing Address - Phone:617-849-2144
Mailing Address - Fax:
Practice Address - Street 1:500 W GERMANTOWN PIKE
Practice Address - Street 2:
Practice Address - City:PLYMOUTH MEETING
Practice Address - State:PA
Practice Address - Zip Code:19462-1353
Practice Address - Country:US
Practice Address - Phone:617-849-2144
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-24
Last Update Date:2021-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAF03745237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist