Brustein, Alicia Taylor
Brustein, Alicia Taylor is an individual health care provider with primary practice located at 425 North 21St Street Suite 405, Camp Hill PA 17011. She recently has 3 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, Physician Assistants & Advanced Practice Nursing Providers / Surgical, Physician Assistants & Advanced Practice Nursing Providers / Medical. Physician Assistants & Advanced Practice Nursing Providers / Medical is her primary health care specialty. Brustein, Alicia Taylor can be contacted via phone (717) 695-6553.Contact Information
Primary practice address
425 North 21St Street Suite 405
Camp Hill PA 17011
Phone: (717) 695-6553
Fax: (855) 383-3233
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant | 363A00000X | OA004204 | Pennsylvania |
| Physician Assistants & Advanced Practice Nursing Providers / Surgical | 363AS0400X | MA060420 | Pennsylvania |
| Physician Assistants & Advanced Practice Nursing Providers / Medical | 363AM0700X | MA060420 | Pennsylvania |
Profile Details
| NPI number | 1639609696 |
|---|---|
| LBN Legal business name | Brustein, Alicia Taylor |
| Credentials | Physician Assistant (PA) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 13th, 2017 |
| Last updated | Jul 31st, 2019 - about 6 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1639609696 | NPPES |
| Pennsylvania | Other | MA060420 | NEW LICENSE NUMBER |
| Pennsylvania | MEDICAID | 103340644 | NEW LICENSE NUMBER |
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