Provider Demographics
NPI:1689012874
Name:BROWN, BRIDGETT DUARTE (PA-C)
Entity Type:Individual
Prefix:
First Name:BRIDGETT
Middle Name:DUARTE
Last Name:BROWN
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:8200 HENRY AVE
Mailing Address - Street 2:SUITE G1
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19128-2984
Mailing Address - Country:US
Mailing Address - Phone:215-482-2336
Mailing Address - Fax:215-483-4389
Practice Address - Street 1:8200 HENRY AVE
Practice Address - Street 2:SUITE G1
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19128-2984
Practice Address - Country:US
Practice Address - Phone:215-482-2336
Practice Address - Fax:215-483-4389
Is Sole Proprietor?:No
Enumeration Date:2013-06-10
Last Update Date:2013-06-10
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant