Pukenas, Bryan A.
Pukenas, Bryan A. is an individual health care provider with primary practice located at 3400 Spruce Street Ground Floor Dulles, Philadelphia PA 19104-4206. He recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Neuroradiology, Allopathic & Osteopathic Physicians / Radiation Oncology, Allopathic & Osteopathic Physicians / Diagnostic Radiology. Allopathic & Osteopathic Physicians / Radiation Oncology is his primary health care specialty. Pukenas, Bryan A. can be contacted via phone (215) 662-3005.Contact Information
Primary practice address
3400 Spruce Street Ground Floor Dulles
Philadelphia PA 19104-4206
Phone: (215) 662-3005
Fax: (215) 662-7011
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Neuroradiology | 2085N0700X | MD434337 | Pennsylvania |
| Allopathic & Osteopathic Physicians / Radiation Oncology | 2085R0001X | MD434337 | Pennsylvania |
| Allopathic & Osteopathic Physicians / Diagnostic Radiology | 2085R0202X | MT182146 | Pennsylvania |
| Allopathic & Osteopathic Physicians / Diagnostic Radiology | 2085R0202X | MD434337 | Pennsylvania |
| Allopathic & Osteopathic Physicians / Diagnostic Radiology | 2085R0202X | 25MA08447100 | New Jersey |
| Allopathic & Osteopathic Physicians / Diagnostic Radiology | 2085R0202X | 25MA08447100 | Pennsylvania |
Profile Details
| NPI number | 1588713499 |
|---|---|
| LBN Legal business name | Pukenas, Bryan A. |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jan 9th, 2007 |
| Last updated | Sep 25th, 2012 - about 12 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 | 1588713499 | NPPES |
| New Jersey | MEDICAID | 0176044 | |
| New Jersey | MEDICAID | 102134964-0001 |
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