Provider Demographics
NPI:1255365367
Name:BOBRIN, BRADFORD DAVID (MD)
Entity type:Individual
Prefix:DR
First Name:BRADFORD
Middle Name:DAVID
Last Name:BOBRIN
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 1:838 PENN ST
Mailing Address - Street 2:
Mailing Address - City:READING
Mailing Address - State:PA
Mailing Address - Zip Code:19602-1108
Mailing Address - Country:US
Mailing Address - Phone:610-988-5830
Mailing Address - Fax:610-988-4822
Practice Address - Street 1:838 PENN ST
Practice Address - Street 2:
Practice Address - City:READING
Practice Address - State:PA
Practice Address - Zip Code:19602-1108
Practice Address - Country:US
Practice Address - Phone:610-988-5830
Practice Address - Fax:610-988-4822
Is Sole Proprietor?:No
Enumeration Date:2006-07-11
Last Update Date:2016-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD4253912084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1012192430001Medicaid
PA001728716OtherHIGHMARK BC/BS
PA088997Medicare UPIN
PA1012192430001Medicaid