Individual
SCOTT A BRALOW
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
301 CITY AVE, SUITE 100, BALA CYNWYD, PA 19004-1708
(610) 660-8864
(610) 660-0877
Mailing address
301 CITY AVE, SUITE 100, BALA CYNWYD, PA 19004-1708
(610) 660-8864
(610) 660-0877
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
OS-006582-L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
552065
MEDICARE ID
PA
Enumeration date
04/10/2006
Last updated
11/07/2007
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