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Organization

DAVID BRONSTEIN DO RICHARD H JEFFRIES DO PROFESSIONAL ASSOC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. DAVID BRONSTEIN D.O. (PRESIDENT)
(717) 657-2595
Entity
Organization

Contact information

Practice address
4830 LONDONDERRY RD, HARRISBURG, PA 17109-5207
(717) 657-2595
(717) 441-0116
Mailing address
4830 LONDONDERRY RD, HARRISBURG, PA 17109-5207
(717) 657-2595
(717) 441-0116

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
PA
207RH0003X
Hematology & Oncology Physician
PA
207RI0200X
Infectious Disease Physician
PA
363AM0700X
Medical Physician Assistant
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0010733600018
PA
01
02790500
CAPITAL BLUE CROSS
PA
01
133259
PA BLUE SHIELD
PA
01
2425999
AETNA
PA
01
CE3282
RR MEDICARE
PA
Enumeration date
06/24/2005
Last updated
07/21/2022
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