Doctor Name: | CARROL BRANDT |
NPI Number: | 1184877037 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | NP |
License Number: | 420802 |
Business Practice Address: | 284 Pulaski Rd Greenlawn, NY - 117401602 |
Business Phone Number: | 6314255250 |
Business Fax Number: | |
Mailing Address: | 59 Georgia Dr, SYOSSET |
State: | NY |
Postal Code: | 117914823 |
Phone Number: | 5165265356 |
Fax Number: | |
NPI Enumeration Date: | 10/23/2008 |
NPI Last Update Date: | 10/23/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LW0102X |
License Number: | 420802 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NY |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Women's Health |
Taxonomy Definition: |