Provider Demographics
NPI:1811000300
Name:BRAUNFELD, ROBERT J (DO)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:J
Last Name:BRAUNFELD
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:2000 SPROUL RD SUITE 100
Mailing Address - Street 2:MARPLE COMMOMS
Mailing Address - City:BROOMAL
Mailing Address - State:PA
Mailing Address - Zip Code:19008-2424
Mailing Address - Country:US
Mailing Address - Phone:670-353-3500
Mailing Address - Fax:610-353-2015
Practice Address - Street 1:2000 SPROUL RD SUITE 100
Practice Address - Street 2:MARPLE COMMOMS
Practice Address - City:BROOMAL
Practice Address - State:PA
Practice Address - Zip Code:19008-2424
Practice Address - Country:US
Practice Address - Phone:670-353-3500
Practice Address - Fax:610-353-2015
Is Sole Proprietor?:No
Enumeration Date:2006-08-17
Last Update Date:2009-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS 002685L207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0072227606OtherAMERICHOICE
PA112605OtherCOVENTRY
PA0007222760006Medicaid
PA2538050OtherAETNA
PA010033425OtherMEDICARE RR
PA0032062000OtherIBC PRODUCTS
PAP663884OtherOXFORD
PA0032062000OtherKEYSTONE
PA064588OtherPA BLUE SHIELD
PA30010228OtherKEYSTONE MERCY
PA010033425OtherMEDICARE RR
PAB34709Medicare UPIN