Provider Demographics
NPI:1659532752
Name:DR.VIKTOR BRIKER P.C.
Entity Type:Organization
Organization Name:DR.VIKTOR BRIKER P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:VIKTOR
Authorized Official - Middle Name:
Authorized Official - Last Name:BRIKER
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:215-355-6197
Mailing Address - Street 1:842 RED LION RD STE 18
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19115-1475
Mailing Address - Country:US
Mailing Address - Phone:215-856-9810
Mailing Address - Fax:215-856-9820
Practice Address - Street 1:842 RED LION RD STE 18
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19115-1475
Practice Address - Country:US
Practice Address - Phone:215-856-9810
Practice Address - Fax:215-856-9820
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-20
Last Update Date:2008-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA0EG000084261QH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA019214Medicare PIN
1273380001Medicare NSC