Provider Demographics
NPI:1932305075
Name:MCGETTIGAN, BRIAN (MD)
Entity Type:Individual
Prefix:DR
First Name:BRIAN
Middle Name:
Last Name:MCGETTIGAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3300 TILLMAN DR
Mailing Address - Street 2:1ST FLOOR
Mailing Address - City:BENSALEM
Mailing Address - State:PA
Mailing Address - Zip Code:19020-2071
Mailing Address - Country:US
Mailing Address - Phone:215-244-2430
Mailing Address - Fax:215-244-2435
Practice Address - Street 1:3300 TILLMAN DR
Practice Address - Street 2:1ST FLOOR
Practice Address - City:BENSALEM
Practice Address - State:PA
Practice Address - Zip Code:19020-2071
Practice Address - Country:US
Practice Address - Phone:215-244-2430
Practice Address - Fax:215-244-2435
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-25
Last Update Date:2013-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMT190820207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA102848538 0001Medicaid
NJ0365424Medicaid
NJ0365424Medicaid