MRS. ALICIA TAYLOR BRUSTEIN (NPI# 1639609696) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1639609696 |
| Entity Type | Individual |
| Full Name | MRS. ALICIA TAYLOR BRUSTEIN |
| Other Name | MS. ALICIA TAYLOR GARBADE |
| Credential | PA |
| Practice Address |
425 North 21st Street Suite 405 Camp Hill PA 17011 |
| Practice Telephone | 7176956553 |
| Practice Fax Number | 8553833233 |
| Mailing Telephone | 7176956553 |
| Mailing Fax Number | 8553833233 |
| Enumeration Date | 2017-06-13 |
| Last Update Date | 2019-07-31 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363A00000X | Physician Assistant | OA004204 | PA | Physician Assistants & Advanced Practice Nursing Providers |
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
MA060420 | PA | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
MA060420 | PA | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PA | NEW LICENSE NUMBER | MA060420 | 01 |
| PA | 103340644 | 05 |
| Street Address |
425 NORTH 21ST STREET SUITE 405 |
| City | CAMP HILL |
| State | PA |
| Zip Code | 17011 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790241628 | Harrisburg Home Care | Home Health | 1713 Hammel Road, R2, Harrisburg, PA 17011 | 2019-02-15 |
| 1427540269 | Eldercare Solutions LLC | Adult Companion | 1926 Market Street, Camp Hill, PA 17011 | 2018-06-06 |
| 1538680244 | Edward Joseph Hilton | Dentist | 3412 Trindle Road, Camp Hill, PA 17011 | 2017-07-03 |
| 1285166843 | Betsy Earnest, Lpc, LLC | Counselor | 1509 Cedar Cliff Drive, Suite 4, Camp Hill, PA 17011 | 2017-03-31 |
| 1962852368 | Angela Antonia Debo | Family Medicine | 3025 Market Street, Entrance B, Camp Hill, PA 17011 | 2016-06-16 |
| 1033567839 | Timothy Zack Day | Physician Assistant | 897 Poplar Rd, Camp Hill, PA 17011 | 2016-06-02 |
| 1962864892 | Tracy Byra | Registered Nurse | 15 Scarsdale Drive, Camp Hill, PA 17011 | 2016-03-21 |
| 1245634138 | Charlotte Diane Hain | Psychologist | 781 Poplar Church Road, Camp Hill, PA 17011 | 2014-10-21 |
| 1205276805 | Isaac S Chiang | Optometrist | South 32nd Street & Trindle Rd, Camp Hill, PA 17011 | 2013-06-27 |
| 1619313376 | Alyson Heller | Dietitian, Registered | 108 Park Pl, Camp Hill, PA 17011 | 2013-05-21 |
| Find all providers in zip 17011 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215417043 | Grant A Meckley | Physician Assistant | 100 Corporate Center Dr Ste 100, Camp Hill, PA 17011-1758 | 2018-08-21 |
| 1851388839 | Julia S Deputy | Physician Assistant | 897 Poplar Church Rd, Camp Hill, PA 17011-2206 | 2005-10-04 |
| 1184109837 | Margaret Elizabeth Hornbake | Physician Assistant | 503 N 21st St, Camp Hill, PA 17011-2204 | 2018-09-28 |
| 1649770918 | Rachael Marie Rock | Physician Assistant | 875 Poplar Church Rd, Camp Hill, PA 17011-2203 | 2018-02-13 |
| 1245777192 | Leah Anne Reitzi | Physician Assistant | 503 N 21st St, Camp Hill, PA 17011-2204 | 2017-01-30 |
| 1255700845 | Molly Zielen | Physician Assistant | 890 Poplar Church Rd, Suite 508, Camp Hill, PA 17011-2250 | 2015-09-24 |
| 1003217100 | Heather Bowman | Physician Assistant | 101 Erford Rd, Camp Hill, PA 17011-1802 | 2014-09-08 |
| 1679903611 | Elizabeth Mary Smith | Physician Assistant | 3912 Trindle Rd, Camp Hill, PA 17011-4246 | 2013-11-12 |
| 1104162361 | Sumana Nagavalli | Physician Assistant | 899 Poplar Church Rd, Camp Hill, PA 17011-2206 | 2012-12-17 |
| 1760770697 | Emily Grace Hahn | Physician Assistant | 3025 Market St, Camp Hill, PA 17011-4518 | 2011-07-12 |
| Find all providers in CAMP HILL | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.