# GREGORY M BRACCIA MD LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1124207865
- **Authorized official:** BERNADETTE N SCARDUZIO (BILLING MANAGER)
- **Authorized official phone:** (484) 452-8003

## Contact information

- **Practice address:** 945 CHESTERBROOK BLVD, CHESTERBROOK, PA 19087-5614
- **Practice address phone:** (610) 695-8088
- **Practice address fax:** (610) 695-6356
- **Mailing address:** PO BOX 546, WAYNE, PA 19087-0546
- **Mailing address phone:** (484) 452-8003
- **Mailing address fax:** (610) 879-5129

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208VP0000X | Pain Medicine Physician | MD0489261 | PA | Yes |

## Other

- **Enumeration date:** 10/30/2007
- **Last updated:** 12/06/2007