Individual
KENNETH J BRISLIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
250 CETRONIA ROAD, SUITE 303, ALLENTOWN, PA 18104-9168
(610) 973-6200
(610) 973-6546
Mailing address
PO BOX 848269, BOSTON, MA 02284-8269
(610) 973-1700
(610) 973-1778
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
MD074181L
PA
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
Primary
MD074181L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1011059120001
—
PA
01
—
1637940
BLUE SHIELD
PA
01
—
2000705
KEYSTONE CENTRAL
PA
01
—
2312743000
KEYSTONE EAST
PA
01
—
50041754
BLUE CROSS
PA
01
—
7716478
AETNA
PA
01
—
821238
FIRST PRIORITY HEALTH
PA
01
—
89078
GEISINGER
PA
01
—
P00146237
RAILROAD MEDICARE
PA
01
—
P3462562
OXFORD
PA
Enumeration date
08/23/2005
Last updated
01/16/2014
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