Individual
JAY KENNETH BRUBAKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2110 HARRISBURG PIKE, SUITE 300, LANCASTER, PA 17604-3200
(717) 544-3022
(717) 544-3021
Mailing address
2110 HARRISBURG PIKE, SUITE 300, LANCASTER, PA 17604-3200
(717) 544-3022
(717) 544-3021
Taxonomy
Speciality
Code
Description
License number
State
207QG0300X
Geriatric Medicine (Family Medicine) Physician
Primary
MD012919E
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000687604
—
PA
05
—
0006876040001
—
PA
05
—
0006876040002
—
PA
05
—
0006876040004
—
PA
01
—
01350102
CAPITAL BLUE CROSS
PA
01
—
127131
HIGHMARK BLUE SHIELD
PA
01
—
20011 S101
GEISINGER HEALTH PLAN
PA
01
—
4662910
AETNA NON-HMO
PA
01
—
516348
AETNA HMO
PA
01
—
P002665
GATEWAY HEALTH PLAN
PA
Enumeration date
01/23/2006
Last updated
03/30/2011
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