Individual
CASEY BREW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MMS, CGC, PA-C
Contact information
Practice address
5501 OLD YORK RD, PHILADELPHIA, PA 19141-3018
(215) 456-7890
Mailing address
603 LONGACRE LN, ISLAND LAKE, IL 60042-9681
(847) 217-1021
(312) 942-2857
Taxonomy
Speciality
Code
Description
License number
State
170300000X
Genetic Counselor (M.S.)
246.000330
IL
363AM0700X
Medical Physician Assistant
Primary
MA064717
PA
Other
Enumeration date
11/07/2017
Last updated
11/28/2023
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