Individual
DORISSA LEA BRIVCHIK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
5500 CORPORATE DR STE 320, PITTSBURGH, PA 15237-5848
(412) 435-1170
(412) 435-1171
Mailing address
801 YORK ST, MANITOWOC, WI 54220-4630
(920) 663-9008
(920) 684-1439
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
MA061319
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
103837118
—
PA
01
—
15002512
CAQH
—
Enumeration date
01/15/2020
Last updated
09/14/2021
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