Individual
ANNA R BRODE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
50 MOISEY DR STE 210, HAZLE TOWNSHIP, PA 18202-9297
(570) 501-6380
(570) 501-6389
Mailing address
PO BOX 783311, PHILADELPHIA, PA 19178-3311
(484) 884-4500
(484) 884-0699
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
MA055805
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
103218100-0001
—
PA
Enumeration date
10/05/2012
Last updated
07/31/2023
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