Staci Jill Braverman, PHYSICAL THERAPIST

Primary specialty

Pediatric Physical TherapistTaxonomy code 2251P0200X

License

PT015040 Issued in PA

Practice address

10521 Drummond Rd
Philadelphia, PA 19154-3807

Phone

(267) 236-3630

Fax

(215) 613-1033

NPI assigned

Apr 2, 2007

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Special People in Northeast, Inc.

  • Local Education Agency (LEA)
  • Philadelphia, PA
  • NPI 1780710137
  NPD (past)
• Special People in Northeast, Inc.

  • Home Health Agency
  • Philadelphia, PA
  • NPI 1922135219
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1175472000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1174644777",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2001 HAMILTON ST",
            "address_2": "#417",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191304201",
            "telephone_number": "267-236-3630",
            "fax_number": "215-613-1033"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10521 DRUMMOND RD",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191543807",
            "telephone_number": "267-236-3630",
            "fax_number": "215-613-1033"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRAVERMAN",
        "first_name": "STACI",
        "middle_name": "JILL",
        "name_prefix": "Ms.",
        "credential": "PHYSICAL THERAPIST",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-02",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251P0200X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Pediatrics",
            "state": "PA",
            "license": "PT015040",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rachel M Braun, ATR-BC, LPC
• Stephanie Braun
• Aliza S Braverman, MD
• Coral Braverman
• Debra L Braverman, M.D.
• Bravo Health Advanced Care Center, P.C.
• Bravo Health Pennsylvania, Inc.
• Itzel Vanessa Bravo, RPH
• Paco Eduardo Bravo, MD
• Willie C Brawn, MHP

• Pediatric Physical Therapist in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Pediatric Physical Therapist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.