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Individual

DR. BRIAN JERUSIK

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.O.

Contact information

Practice address
1020 SANSOM ST, STE 239, PHILADELPHIA, PA 19107-5002
(215) 955-6844
(215) 955-2526
Mailing address
1020 SANSOM ST, STE 239, PHILADELPHIA, PA 19107-5002
(215) 955-6844
(215) 955-2526

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
OS015863
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0293822
NJ
05
102747713
PA
Enumeration date
04/01/2009
Last updated
12/11/2012
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