BRYAN DENNIS BOOTH PA-C NPI 1548235179

NPI Information

NPI: 1548235179
Provider Name: BRYAN DENNIS BOOTH, PA-C
Classification: Physician Assistant - 363AM0700X
Entity Type: Individual

Specialization: Medical

PECOS Registration: Yes

Address:
3400 SPRUCE ST
6 SILVER
PHILADELPHIA, PA
ZIP 19104
Phone: (215) 615-4949
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Bryan Dennis Booth, PA-C is a medical physician assistant in Philadelphia, PA. Bryan Dennis Booth, PA-C NPI is 1548235179. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

3400 SPRUCE ST
6 SILVER
PHILADELPHIA, PA
ZIP 19104-238
Phone: (215) 615-4949

The NPI 1548235179 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 2/17/2006 and was last updated on 6/12/2015.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363AM0700X	Physician Assistant	Medical	MA001415L	PENNSYLVANIA	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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