Individual
TECLA M BRABAZON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
2545 SCHOENERSVILLE RD, BETHLEHEM, PA 18017-7300
(484) 884-2888
(484) 884-2885
Mailing address
2545 SCHOENERSVILLE RD, BETHLEHEM, PA 18017-7300
(484) 884-2888
(484) 884-2885
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
OT010550
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
102078195
—
PA
01
—
2015434
BLUE SHIELD
PA
Enumeration date
05/15/2007
Last updated
06/27/2008
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