Basic Information
| Provider Information | |||||||||
| NPI: | 1154811313 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | DURKIN | ||||||||
| FirstName: | BRIDGET | ||||||||
| MiddleName: | REILLY | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | MD, MBE | ||||||||
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| Mailing Information | |||||||||
| Address1: | INTERNAL MEDICINE RESIDENCY PROGRAM, DEPT. OF MEDICINE | ||||||||
| Address2: | 3400 SPRUCE STREET, 100 CENTREX | ||||||||
| City: | PHILADELPHIA | ||||||||
| State: | PA | ||||||||
| PostalCode: | 19104 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2156622200 | ||||||||
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| Practice Location | |||||||||
| Address1: | 3400 SPRUCE ST | ||||||||
| Address2: | |||||||||
| City: | PHILADELPHIA | ||||||||
| State: | PA | ||||||||
| PostalCode: | 191044238 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2156624000 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 05/14/2018 | ||||||||
| LastUpdateDate: | 05/14/2018 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 390200000X | Y | Student, Health Care | Student in an Organized Health Care Education/Training Program |
No ID Information.