Provider Demographics
NPI:1891258216
Name:EMMERT, BRIAN EDWARD JR (MD)
Entity type:Individual
Prefix:DR
First Name:BRIAN
Middle Name:EDWARD
Last Name:EMMERT
Suffix:JR
Gender:M
Credentials:MD
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Mailing Address - Street 1:710 W 168TH ST FL 7
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10032-3726
Mailing Address - Country:US
Mailing Address - Phone:212-305-7950
Mailing Address - Fax:
Practice Address - Street 1:3400 CIVIC CENTER BLVD
Practice Address - Street 2:2ND FLOOR SOUTH PAVILION, PENN NEUROSCIENCE CENTER
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19104
Practice Address - Country:US
Practice Address - Phone:215-662-3606
Practice Address - Fax:215-349-5579
Is Sole Proprietor?:Yes
Enumeration Date:2019-04-11
Last Update Date:2025-05-23
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Provider Licenses
StateLicense IDTaxonomies
PAMD4800332084E0001X
NY3352352084E0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084E0001XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyEpilepsyGroup - Single Specialty