Individual
BRITTANI IMBRIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
235 GLEN COVE RD, CARLE PLACE, NY 11514-1221
(516) 877-2273
(516) 877-2275
Mailing address
5501 OLD YORK RD, PHILADELPHIA, PA 19141-3018
(215) 456-7890
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
020754
NY
363AM0700X
Medical Physician Assistant
MA056897
PA
390200000X
Student in an Organized Health Care Education/Training Program
MA056897
PA
Other
Enumeration date
06/25/2014
Last updated
06/12/2019
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