Individual
MARY M BRACHA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
3201 RACE STREET, APT1001, PHILADELPHIA, PA 19104-0000
(610) 619-8590
Mailing address
10330 N MERIDIAN ST # 300, INDIANAPOLIS, IN 46290-1024
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
SP019005
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
103562366
—
PA
Enumeration date
07/31/2016
Last updated
02/18/2019
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